THE TREATMENT OF THE DU, REN AND CHONG MAI

Copyright Giovanni Maciocia

TABLE OF CONTENTS

Pathway of the Du Mai

Du Mai-Ren Mai-Uterus

Clinical Application of the Du Mai

Tonification of Kidney-Yang

Strengthening the Back

Nourish the Brain and Marrow

Strengthen the Shen

Expel Exterior Wind

Extinguish Interior Wind

The Du Mai in Gynaecology

The Du Mai and the Fire of the Ming Men

Tonify Heart-Yang

Lift Qi

The Du Mai and the Male Genital System

Pulse of the Du Mai

Classical Indications

Points of the Du Mai

Herbal Therapy

The Ren Mai

Pathway

Du Mai-Ren Mai-Uterus

The Four Phases of the Menstrual Cycle

Clinical Applications of the Ren Mai

Nourishing Yin

Regulates the Uterus

Regulation of Life Cycles

Move Qi in the Lower Burner

Promote the Descending of Lung-Qi and the Kidney’s Receiving of

Qi

Promote the Transformation, Transportation and Excretion of Fluids

The Ren Mai and the Male Genital System

Combination of Ren and Du Mai Points

The Pulse of the Ren Mai

Classical Indications

Points of the Ren Mai

Herbal Therapy

Chong Mai

Body Areas Influenced

Meaning of Name

Pathway

Significance of the Branches of the Chong Mai

Clinical Significance of the Various Names of Chong Mai

The Concept of “Streets”, “Avenues” or “Crossroads” (JIE)

Sea of the 5 Zang and the 6 Fu

The Chong Mai in Gynaecology

Chong Mai Rebellious Qi

The Chong Mai and the Membranes (HUANG)

The Chong Mai and the Female Breast

The Chong Mai and the Heart

The Chong Mai and the Stomach

The Chong Mai and the Qi Circulation to Feet

The Chong Mai and the “Ancestral Muscle” (Zong Jin)

The Chong Mai and the Male Genital System

Comparison and Differentiation between the Ren and Chong Mai

Pulse of the Chong Mai

Points of the Chong Mai

Herbal Therapy

DU MAI 督 脉

THE GOVERNING VESSEL

Giovanni Maciocia

This pathway is more complex than a mere line arising from the

perineum and flowing along the spine to the head and upper lip.

THE INTERNAL PATHWAY OF THE DU MAI

First of all, it originates in

between the two kidneys

(together with the Ren and

Chong Mai)

it then flows downwards to the

perineum and emerges at Ren-1

Huiyin.

It starts in between the kidneys where the Dong Qi throbs, it goes to the

uterus and the pubic bone. In women, it flows around the vagina, passes to

the perineum, then the buttocks to meet the Kidney and Bladder channels in

the thighs. In men, it flows around the penis and goes to the perineum.

Su Wen Chapter 60

PATHWAY ACCORDING TO CLASSICAL TEXTS

“The Du Mai arises within the lower abdomen, externally in the abdomen,

internally in the “bao” (also called “dantian”) in both men and women: in

women it is the uterus, in men it is the Room of Sperm.”

Yi Zong Jin Jian

Another branch originates from the Liver channel on

the vertex and it flows down the right and left side

of the spine, entering the spine muscles and the

Bladder channel. In the lumbar region, it enters the

kidneys.

Ling Shu Chapter 10

ABDOMINAL BRANCH OF DU MAI

“Su Wen” Chapter 60

The abdominal branch of the Du Mai starts in the

perineum, flows up the abdomen (in the midline),

up to the umbilicus, past the heart, throat, chin,

around the lips and reaches the eyes.

DU AND REN VESSELS

Li Shi Zhen:

“The Ren and Du Mai are two branches from the same source,

one in the front of the body, the other in the back. Just as the

human body has the Ren and Du Mai, nature has midnight and

midday: these two vessels are separate but also joined. When we

try to divide these, we see that Yin and Yang are inseparable;

when we try to see them as one, we see that it is an indivisible

whole. They are one but two, they are two but one.”

Ren Du

HEART

KIDNEYS

UTERUS

Ren Mai

Du Mai

DU MAI – REN MAI - UTERUS

Bao Mai

Bao Luo

HYPOTHALAMUS-PITUITARY-OVARY AXIS

HEART

KIDNEY

UTERUS

Bao Mai = Chong

Bao Luo = Ren/Du

Du and Ren control the ebb and flow of Yin-Yang in the menstrual

cycle. The two Qiaos help the balance of Yin-Yang while the two

Weis control the connection of Yin-Yang. They have a secondary role

in the regulation of the menstrual cycle as they do not flow through

the uterus.

Brain

Ren

Mai

Du

Mai

Ren-1

DU MAI

REN MAI

Pituitary

Hypotha lamus

Ovary

REN

Uterus

HYPOTHALAMUS

PITUITARY

FOLLICLE CORPUS LUTEUM

UTERUS

Oestrogen Progesterone

Gonadotropin releasing hormone GnRH

FSH LH

CLINICAL APPLICATIONS: SEA OF YANG CHANNELS

The Du Mai is called the “Sea of Yang channels” as it exerts an

influence on all the Yang channels and it can be used to strengthen

the Yang of the body. It can tonify Kidney-Yang. The tonification

of Yang is an important aspect of the Du Mai’s functions.

The Du Mai also nourishes the spine and as its inner pathway

enters the brain, it can be used to strengthen the Kidney function

of nourishing Marrow and Brain for such symptoms as dizziness

and poor memory.

1. TONIFICATION OF KIDNEY-YANG

Being the governor of all Yang of the body, the Du Mai can be used to

tonify Yang; particularly Kidney-Yang in both men and women.

To tonify Kidney-Yang firstly I use the opening and coupled points of

the Du Mai : S.I.-3 Houxi on one side, BL.-62 Shenmai on the other

for about 15-20 minutes. Then the patient turns over for direct moxa

on Du-4 Mingmen, which powerfully tonifies Kidney-Yang.

To strengthen Kidney-Yang and the Fire of Ming Men, moxa Du-4

Mingmen and BL-23 Shenshu simultaneously. Contraindicated in

cases of Heat anywhere in the body, including deficiency Heat.

2. STRENGTHENING THE BACK

The Du Mai is extremely useful in all cases of chronic lower backache

due to Kidney deficiency, especially when the pain is either on the

midline of the back or is bilateral but stems from the midline. I do not

use the Du Mai when the pain is unilateral.

The Du Mai opening and coupled points are used first for about 10–15

minutes, opening the Du Mai and making it more receptive to further

treatment with local points, as well as straightening the spine.

After this, local points can be used, particularly Du-3 Yaoyangguan or the

extra point Shiqizhuixia situated on the midline below the tip of L-5

lumbar vertebra, BL-26 Guanyuanshu bilaterally.

The use of the opening and coupled points can strengthen the

back and actually straighten the spine.

In women, it can be combined with the Ren Mai, crossing over

the opening and coupled points, as in the treatment of Kidney-

Yang. In men, the Du Mai can be used on its own.

In women, I use S.I.-3 Houxi on the right, BL-62 Shenmai on the

left. It is sometimes useful to combine the opening points of the

Du and Ren Mai: particularly in pronounced Kidney deficiency

with gynaecological symptoms.

In such cases, use: S.I.-3 Houxi on the right, BL-62 Shenmai on

the left, LU-7 Lieque on the left and KI-6 Zhaohai on the right,

the needles inserted in this order and taken out in reverse order.

.

. .

.

In men, I use S.I.-3 Houxi on the left followed by BL-62

Shenmai on the right.

The Du Mai is also used for neurological disorders for two reasons.

From the Chinese point of view, it is the Sea of all Yang channels

and therefore stimulates motility.

From the Western point of view, it treats the spine and motor and

sensory nerves. In Multiple Sclerosis, it treats the demyelinazation

of the myelin sheath.

The Kidney-Jing produces Marrow which fills the spine

and the Brain. Flowing inside the spine and into the

brain, the Du Mai has a deep influence on the

nourishing of the brain.

In particular, the Du Mai balances Yin and Yang in the

head and brain as it carries Kidney-Jing but is itself Yang

in nature.

The Du Mai connects upwards with the Brain and

downwards with the Kidneys: it is therefore the channel

connection between Kidneys and Brain. The Kidneys

store Jing and the Brain is filled by Marrow: to nourish

the Jing and fill Marrow one can use the Du Mai.

3. NOURISH THE BRAIN AND MARROW

Cheng Xing Gan

“When Marrow is full thinking is clear. Too much thinking leads to

Heart-Fire which burns the brain causing dizziness, blurred vision,

tinnitus . . . The Marrow is rooted in the Jing and connects downwards

with the Du Mai: when the Ming Men warms and nourishes, the Marrow

is full.”

Hence Heart, Brain and Kidneys are all related to the Du Mai with a relation

of mutual nourishment and influence.

Tonifying the Du Mai therefore can nourish the Marrow and the brain for

such symptoms as:

dizziness

tinnitus

weak legs

blurred vision

a desire to lie down

The points that affect the Sea of Marrow are: Du-16 Fengfu and Du-20

Baihui

The Du Mai enters the brain at Du-16 Fengfu from where it proceeds

upwards (chapter 28 of the “Nan Jing”).

4. STRENGTHEN THE MIND (SHEN)

Ling Shu Chapter 8

The Mind (Shen) is closely related to the Kidney- Jing.

“Life comes about through the Jing; when the two Jing [of mother and

father] unite, they form the Shen.”

Zhang Jie Bin

“The two Jing, one Yin, one Yang, unite . . . to form life; the Jing of mother

and father unite to form the Shen.”

Therefore the Shen comes into being originally from the Pre-Natal Jing

which is stored in the Kidneys. Of course, after birth, it is

supplemented by the Post-Natal Jing.

As the Brain was considered by some Chinese doctors to be the seat of

the Mind (Shen) together with the Heart, treatment of the Du Mai

influences the Mind profoundly because it treats both Kidney-Jing and

the Brain. It is important in the treatment of depression.

Although the Mind (Shen) is housed in the Heart, its foundation is in the

Kidney-Jing. As Kidney-Jing produces Marrow which fills the Brain, there

were, over the centuries, Chinese doctors who attributed mental functions

and consciousness to the Brain rather than the Heart.

Note: regarding the Kidney-Jing being the foundation of the Shen see the

point G.B.-13 Benshen which brings Jing to the head. “Benshen” means

“foundation” or “root” of the Shen, which are the Kidneys.

This is the meaning of Li Shi Zhen's reference to the Brain being the

residence of the Original Mind (Yuan-Shen), i.e. the Brain is formed from

Marrow and Kidneys which store the Pre-Natal Jing that is the origin of

the Shen.

In fact the Shen is housed indeed in the Heart, but it also resides in the Brain

and originates from the Pre-Natal Jing.

Therefore in order to “strengthen” the Shen, it is necessary to treat both the

Heart and the Kidneys. i.e., in depression it is often necessary to tonify both

the Kidneys and the Heart and therefore Zhi and Shen.

By its very nature and because of its pathway (its

ascending branch flowing “past the heart”), the Du

Mai can strengthen the Shen by strengthening the

three structures which affect the Shen, i.e. the

Kidneys (and therefore Zhi, Will-Power), the Heart

(Shen, the Mind) and the Brain (also Shen, the

Mind).

Cheng Xing Gan

“When Marrow is full thinking is clear. Too much

thinking leads to Heart-Fire which burns the brain

causing dizziness, blurred vision, tinnitus . . . The

Marrow is rooted in the Jing and connects downwards

with the Du Mai: when the Ming Men warms and

nourishes, the Marrow is full.”

Shen

Zhi

Shen

5. EXPEL EXTERIOR WIND

In attacks of exterior Wind, the Du Mai can be used to release the Exterior and

expel Wind at the Tai Yang stage of the 6 Stages. It is therefore used for such

symptoms as aversion to cold, fever, runny nose, headache, stiff neck and a

Floating pulse.

To expel exterior Wind, the opening points of the Du Mai can be used with

Du-16 Fengfu and in addition to points that expel Wind and reach the

Lung’s Defensive Qi portion such as LU-7 Lieque, L.I.-4 Hegu and T.B.-5

Waiguan: what determines the choice of Du Mai points is the presence of

symptoms along this vessel and the Tai Yang channels of the upper back, i.e.

pronounced occipital stiffness and headache.

6. EXTINGUISH INTERIOR WIND

In conditions of interior Wind, the Du Mai can be used to extinguish

interior Wind, for such symptoms as dizziness, tremors, convulsions,

or for the sequelae of Wind-stroke. Also Parkinson’s disease and the

late stages of multiple sclerosis.

The points to use are the opening and coupled points (S.I.-3 Houxi

and BL-62 Shenmai) together with Du-16 Fengfu and Du-20 Baihui.

7. THE DU MAI IN GYNAECOLOGY

The role of the Du Mai in gynaecology should not be underestimated because:

1. the Du Mai (like the Ren and Chong Mai) arises in the lower Dan Tian

and flows down to the perineum through the uterus

2. the Du Mai has a branch that, from the perineum, flows to the external

genitalia and therefore, in women, the vulva

3. the Du Mai represents the Kidney-Yang in the menstrual cycle.

The Du Mai plays an important role in gynaecology as it represents the

channel through which Yang waxes and wanes during the menstrual

cycle.

Lining is

discharged

Follicle matures Ovulation Lining continues

to thicken

Unfertilized egg

dies

Yang – Du Mai

Yin – Ren Mai

This alternation of Yin and Yang in the menstrual cycle is due to the alternation of

Kidney-Yin and Kidney-Yang: however, in a concrete way, this alternation

determines the menstrual cycle through the Ren Mai (representing Yin), the Chong

Mai (representing Blood) and the Du Mai (representing Yang). As these three

vessels all flow through the Uterus, it is through them that the above alternation of

Yin and Yang in the menstrual cycle actually occurs.

In a nutshell, in gynaecology we can use the Du Mai in any case where we might

use the Ren Mai but where is a pronounced Kidney-Yang deficiency. Indeed,

Chapter 60 of the “Simple Questions” gives the following symptoms for the Du

Mai: “In women, it causes infertility, haemorrhoids, incontinence of urine and a dry

throat.” In this passage, infertility in women is clearly connected with the Du Mai.

The menstrual cycle occurs through the alternation of Kidney-Yin and Kidney-

Yang in a monthly cycle. Yang is at its lowest just before ovulation; it starts to

increase at ovulation and reaches its maximum just before the onset of the

following period. Yin is at its minimum at the end of the period; it reaches its

maximum at mid-cycle and then decreases, reaching its minimum when the next

period starts.

One does not combine the Du with the Ren Mai only in gynaecological

problems: I do so especially in menopausal women in whom there is often

an overlap of Kidney-Yang and Kidney-Yin deficiency.

Bearing in mind that a branch of the Du Mai also goes to the vulva and

vagina, this vessel can be used also for chronic, excessive vaginal

discharge occurring against a background of pronounced Kidney-Yang

deficiency.

Jia Yi Jing on pathology of the ascending branch of the Du Mai:

“Diseases [of the abdominal branch] include pain from the hypogastrium

towards the heart, inability to bend forward or back, Hernial and Genito-

Urinary Disorders [Shan], infertility in women, urinary retention,

haemorrhoids, spermatorrhoea.”

8. THE DU MAI AND THE FIRE OF THE MING MEN

The first discussion of the Ming Men can be found in the: “Nan Jing” Chapter 36

and Chapter 39

“The Kidneys are not really two, as the left Kidney is a Kidney proper and the

right Kidney is the Ming Men. The Ming Men is the residence of the Shen and

is related to the Yuan Qi: in men it stores Jing, in women it is connected to the

uterus. That is why there is only one Kidney.”

“Why does the classic say that there are 5 Zang and and 6 Fu? The reason is

that the Zang count as 6 since there are two Kidneys. The left Kidney is the

Kidney proper, the right Kidney is the Ming Men. . . the reason that there are

6 Fu is that each of the 5 Zang has a corresponding Yang organ, plus an extra

one being the Triple Burner.”

These two passages show that according to the “Nan Jing” the Ming Men

corresponds to the right Kidney, and is therefore functionally inseparable from

the Kidneys. However, for several centuries, up to the Ming dynasty, medical

writers seldom discussed the Ming Men as something separate from the

Kidney, simply referring to it as “Kidney-Qi”.

With the beginning of the Ming dynasty, the concept of the Ming Men

was greatly developed, and ideas on it differed from those expounded

in the “Nan Jing”. During the Ming dynasty, Chinese physicians

considered the Ming Men as occupying the place between the two

Kidneys

Zhang Jie Bin:

“There are two Kidneys . . . the Ming Men is in between them . . . The

Ming Men is the organ of Water and Fire, it is the residence of Yin and

Yang, the Sea of Jing and it determines life and death.”

Zhao Xian He discussed the Ming Men in his book “Medicine

Treasure” (Yi Gui) in 1687. He wrote that the Ming Men is the motive

force of all functional activities of the body, the physiological Fire

which is essential to life. This Fire is also called “True Fire” or

“Minister Fire”.

The importance of the Fire nature of the Ming Men is that it provides

heat for all our bodily functions and for the Kidney-Jing itself. The

Ming Men is the embodiment of the physiological Fire within the

Kidneys and the Minister Fire is a special type of Fire in that not only

does it not extinguish Water, but it can actually produce Water.

The main functions of the Ming Men are:

1. It is the Root of the Yuan Qi

Both Ming Men and Yuan Qi are related to the Kidneys, and are

interdependent. Yuan Qi is a form of dynamically-activated Jing which has

many functions. Yuan Qi relies on heat for its performance and this heat is

provided by the Ming Men. If the Fire of the Ming Men is deficient, Yuan

Qi will suffer, and will inevitably lead to a general deficiency of Qi and

Blood.

2. It is the Source of (physiological) Fire for all the Internal Organs

All the organs rely on the heat provided by the Fire of the Ming Men to

function properly. The Spleen needs its heat to transform and transport

food Jings, the Stomach needs it to rot and ripen food, the Heart needs it

to house the Shen, the Lungs need it to send Qi downwards and to

diffuse Qi, the Liver needs it to ensure the free flow of Qi, the Intestines

need it to move food and stools, the Gall-Bladder needs it to secrete bile,

the Triple Burner needs it to transform and excrete fluids.

If the Fire of the Ming Men declines, the functional activity of all organs

will be impaired, leading to tiredness, mental depression, lack of vitality,

negativity and a pronounced feeling of cold.

3. It warms the Lower Burner and Bladder

The Lower Burner transforms and excretes fluids, with the assistance of the

Bladder. The heat of the Ming Men is essential to transform fluids in the

Lower Burner. If the Ming Men Fire is weak, the Lower Burner and Bladder

will lack the Heat necessary to transform fluids: these will therefore

accumulate giving rise to Dampness or oedema.

4. It warms the Stomach and Spleen to aid digestion

Heat is essential to the Spleen for its functions of transportation,

separation and transformation. All this requires heat supplied by the Ming

Men. If the Fire of the Ming Men is deficient the Spleen cannot transform

and the Stomach cannot digest the food, leading to diarrhoea, tiredness,

cold sensations and coldness of limbs.

5. It harmonizes the sexual function and warms the Jing and Uterus

The Fire of the Ming Men (Minister Fire) is essential for a healthy sexual

function and it warms the Jing and the Uterus. It may be seen as the Yang aspect

of the Jing. Sexual performance, fertility, puberty and menstruation, all depend

on the Fire of the Ming Men. If the Fire of the Ming Men declines, the Jing in

men and the Uterus in women will turn cold, causing impotence and sterility in

men and lack of sexual desire and infertility in women.

6. It assists the Kidney function of reception of Qi

The function of reception of Qi depends on Kidney-Yang which requires

the Fire of the Ming Men for its performance. For Kidney-Yang to

function normally, there must be communication between the Zong Qi of

the chest and the Yuan Qi of the lower abdomen, which itself relies on the

heat from the Ming Men for its activity. If the Fire of the Ming Men is

deficient, the Kidney’s ability to receive Qi will be impaired causing

breathlessness, asthma, a feeling of oppression in the chest and cold hands.

7. It assists the Heart function of housing the Shen

The Fire of the Ming Men has to ascend from the Kidneys and

communicate with the Heart, to provide it with the heat necessary for its

functions. Because of this, the Fire of the Ming Men assists the Heart in

housing the Shen. This means that it has a strong influence on the mental

state and happiness. If the Fire of the Ming Men is deficient, the Heart

cannot house the Shen, and the person will be depressed, be unhappy and

lack vitality. Vice versa, if the Minister Fire of the Ming Men becomes

pathological (from emotional problems, for example), it flares upwards

harassing the Heart and Pericardium and it may cause manic behaviour.

With acupuncture, the Du Mai is the main way to tonify the Fire

of the Ming Men: indeed, the very name of the point Du-4

Mingmen indicates that the Fire of the Ming Men is located on

the Du Mai below the second lumbar vertebrae. In order to

warm the Fire of the Ming Men, one must use direct moxa on

the point Du-4 Mingmen.

9. TONIFY HEART-YANG

The Du Mai can be used to tonify Heart-Yang, partly because it

tonifies Yang in general and partly because, internally, it flows

through the heart. The best point to tonify Heart-Yang through the

Du Mai is Du-14 Dazhui with direct moxa.

Therefore, the Du Mai can be used for depression deriving from

Heart- and Kidney-Yang deficiency.

The best points to use for this condition are S.I.-3 Houxi and BL-

62 Shenmai together with Du-20 Baihui, Du-14 Dazhui and BL-

23 Shenshu.

Du-11 Shendao strengthens the Heart and calms the Mind, treats

sadness, anxiety, poor memory, palpitations, disorientation and

timidity. It is on the same level as BL-15 Xinshu, the Back-Shu

point of the Heart, and its action mostly extends to the Heart. It

nourishes the Heart and calms the Mind.

However, tonifying Heart-Yang through the Du Mai is done not

only for mental-emotional problems but also for physical problems

deriving from Heart-Yang deficiency such as cold hands,

sensations of coldness, palpitations, a slight feeling of oppression

in the chest.

10. LIFT QI

I frequently use the Du Mai to ‘lift’ Qi. This is necessary in cases

when Qi is sinking. “Sinking of Qi” is a pathology of Spleen-

and/or Kidney-Qi.

The Sinking of Spleen-Qi may lead to diarrhoea or prolapse

Sinking of Kidney-Qi may lead to prolapse of the uterus/

bladder, excessive menstrual bleeding.

Lifting Qi may only be used to treat excessive menstrual bleeding

when it is caused by a deficiency and sinking of Qi, not when it is

caused by Blood Heat.

Even if the uterus or bladder do not actually prolapse, sinking of

Kidney-Qi may cause other problems, i.e.;

• frequency and urgency of urination

• slight incontinence associated with a bearing-down feeling in the

lower abdomen (much more common in women).

A bearing-down feeling in the lower abdomen is an important sign

in the diagnosis of sinking of Qi (of Spleen or Kidneys).

2. It tonifies the Kidneys and especially Kidney-Yang.

The Du Mai is particularly effective in treating sinking of Kidney-Qi for

three reasons:

1. It tonifies Yang and therefore it lifts Qi (as ascending is a Yang movement

and needs Yang).

3. Through its abdominal branch, it treats the organs in the lower abdomen

and especially Uterus and bladder.

Kidney-Qi

sinking

excessive

menstrual

bleeding

S.I.-3 Houxi and BL-62

Shenmai

Du-20 Baihui

Ren-4 Guanyuan.

frequent and urgent

urination, slight

incontinence

S.I.-3 Houxi and BL-62

Shenmai

Du-20 Baihui

Ren-3 Zhongji.

In women, I use the same points, with the addition of LU-7 on the left

and KI-6 on the right.

11. THE DU MAI AND THE MALE GENITAL SYSTEM

1) The penis

As discussed above, the Du Mai flows to the front of the body over

the external genitalia and therefore the testicles and penis in men.

The Du Mai represents the influence of Kidney-Yang on the penis

and testis: it is the channel through which Kidney-Yang provides

Heat to the Jing. Thus, the Du Mai represents the Yang aspect of

Jing.

Kidney-Yang also provides the Heat necessary for normal functioning

of the male genital system. For example, Kidney-Yang and the Du Mai

are important to determine a normal erection.

Kidney-Yang deficiency and a weakened Du Mai may cause

erectile dysfunction. To treat this I use the opening and coupled

points of the vessel (S.I.-3 Houxi on the left and BL-62 Shenmai

on the right) with Ren-4 Guanyuan and BL-23 Shenshu.

2. The prostate

The prostate may be thought of as equivalent to the Uterus in women.

Therefore the three vessels that arise in the lower abdomen, the Du,

Ren and Chong Mai, all flow through the prostate on their way down

to Ren-1 Huiyin.

In my opinion, when considering the physiology and pathology

of the prostate gland in Chinese medicine, the seminal vesicles

should be assimilated with the prostate

The prostate is related to the Kidney-Jing, producing, with the seminal

vesicles, about 90% of the seminal fluid. The Du and Ren Mai

influence the prostate and the production of seminal fluid. As sperm is

a form of Jing, it is part of the Yin Jings (and therefore the Ren Mai).

A deficiency of Kidney-Yang and of the Du Mai may cause

abnormalities of the sperm such as a reduced sperm count or impaired

sperm mobility.

However, the production of sperm is dependant on the heat from

Kidney-Yang, and therefore it needs the Du Mai. The two points Ren-

4 Guanyuan and Du-4 Mingmen represent the Yin and Yang aspect of

the Jing respectively: in men, they both are needed for the production

of seminal fluid by the prostate.

Sperm count and motility can be stimulated by using the Du

Mai with its opening and coupled points (S.I.-3 on the left and

BL-62 on the right) together with Du-4 Mingmen, Ren-4

Guanyuan and Ren-6 Qihai.

SUMMARY OF DU MAI CLINICAL APPLICATIONS

12. PULSE OF THE DU MAI

The pulse of the Du Mai is Floating in all three positions.

Pulse Classic (Mai Jing)

“If the pulse is Floating from the Rear to the Front position,

straight up and down, [it] indicates [a pathology of] the Du

Mai. There will be stiffness and pain of the back, inability

to bend forward or backward, madness in adults and

epilepsy in children.”

“When the pulse is Floating in the Middle position,

beating straight up and down, it indicates [a pathology of]

the Du Mai. There is a feeling of cold in the back and

knees, madness in adults and epilepsy in children: moxa

the vertex with three moxa cones; madness in adults and

epilepsy in children: moxa the vertex with three moxa

cones.”

CLASSICAL INDICATIONS

a) PATHOLOGY

Su Wen Chapter 60

“Qi rises from the lower abdomen causing heart pain, retention of urine

and faeces and Hernial and Genito-Urinary Disorders [Shan]. In

women, it causes infertility, haemorrhoids, incontinence of urine and a

dry throat.”

This passage is interesting as it relates abdominal symptoms to the Du

rather than the Ren or Chong Mai: such symptoms are obviously related

to the abdominal branch of the Du Mai described above.

“When the Du Mai is diseased there is stiffness of the spine and

fainting.”

Nan Jing

Li Shi Zhen

“When the Du Mai is full there is rigidity of the back which is bent

backward . . . when it is empty there is a feeling of heaviness of the head

and shaking of the head.”

ABC of Acupuncture (Jia Yi Jing)

“Diseases of the Du Mai include stiffness and arching of the spine.”

Pulse Classic (Mai Jing)

“When the Du Mai is diseased there is stiffness of the spine and

inversion [or breakdown] (jue).”

Golden Mirror of Medicine (Yi Zong Jin Jian)

“Contraction of the hands and feet, tremors of limbs, aphasia from Wind-

stroke, epilepsy, headache, eye swelling with discharge, chronic backache

and knee ache, occipital stiffness from unresolved invasion of Wind-Cold,

toothache, numbness of limbs, night-sweating

This passage also refers to a pathology of the Du Mai caused either by

internal or external Wind.

According to the “Pulse Classic”; mania in adults and epilepsy in

children due to the Du Mai include, for which one must moxa Du-20

Baihui

The “Gatherings from Eminent Acupuncturists” (Zhen Jiu Ju Ying, 1529) lists the following

symptoms and signs for the Du Mai (using S.I.-3 Houxi and BL-62 Shenmai) indicating in

brackets the organ involved:

Spasms of arms and legs (Liver)

Shaking of arms and legs (Liver, Triple

Burner)

Head Wind pain (Triple Burner, Bladder)

Aphasia after Wind-stroke (Liver channel)

Disease from external Wind-Cold (Shang

Han) not abating (Bladder)

Incessant night-sweating (Lungs, Heart)

Toothache (Stomach, Large Intestine)

Epilepsy with foamy vomiting (Stomach)

Stiffness and pain of the back (Kidneys)

Pain of sinews and bones (Liver, Stomach)

Feeling of obstruction of the throat (Stomach, Kidneys,

Lungs)

Swelling and pain of the cheeks and chin (Stomach,

Small Intestine)

Stiffness of pain of the occiput from Wind-Cold

(Shang Han) (Bladder)

Swelling and pain of knees and legs (Kidneys)

Numbness of arms and legs (Stomach)

Swollen and red eyes (Liver, Heart) Inability to sweat (Lungs, Stomach)

Headaches from invasion of Wind-Cold (Bladder)

Tears when exposed to wind (Liver,

Gall-Bladder)

Tremor from invasion of Wind (Liver)

Post-partum sweating with aversion to wind (Lungs)

Spasm of throat (Lungs, Liver)

Pain in the knees, lower legs and thighs

(Stomach)

Painful Obstruction (Bi) Syndrome of the

hands (Large Intestine)

b) POINT COMBINATIONS

Great Compendium of Acupuncture (Zhen Jiu Da Cheng)

“Needle S.I.-3 as Host [point] 1 cun deep to treat diseases of the head, face

and neck; then needle BL-62 Shenmai to combine Host with Guest.”

“First needle S.I.-3 Houxi as Host point, then needle BL-62 Shenmai second as

Guest point.”

The indications and combinations given for these two points in the “Great Compendium of

Acupuncture” are as follows:

- Tremor of limbs with difficulty in walking: L.I.-5 Yangxi, L.I.-11 Quchi, S.I.-4 Wangu, G.B.-34

Yanglingquan, G.B.-39 Xuanzhong, SP-4 Gongsun, LIV-3 Taichong.

- Spasm of hand and foot, difficulty in extending limbs: ST-36 Zusanli, L.I.-11 Quchi, LU-5

Chize, L.I.-4 Hegu, LIV-2 Taichong, G.B.-34 Yanglingquan.

- Stiffness and pain of neck: Ren-4 Guanyuan, G.B.-20 Fengchi, Du-16 Fengfu.

- Swelling of glands of the cheek (possibly mumps): ST-5 Daying, ST-6 Jiache, L.I.-4 Hegu.

- Feeling of obstruction in the throat: L.I.-1 Shangyang, Ren-22 Tiantu, KI-6 Zhaohai, Shixuan.

- Bilateral tonsillitis: LU-11 Shaoshang, Jinjin and Yuyue, Shixuan.

- Unilateral tonsillitis: T.B.-1 Guanchong, Ren-22 Tiantu, L.I.-4 Hegu.

- Headache with pain in the corners of forehead: G.B.-5 Linqi, T.B.-23 Sizhukong, Taiyang, LU-

7 Lieque, L.I.-4 Hegu.

- Pain at the corners of the eyebrows: BL-2 Zanzhu, G.B.-14 Yangbai, Yintang, L.I.-4

Hegu, ST- 8 Touwei.

- Headache and dizziness: Taiyang, L.I.-4 Hegu, ST-8 Touwei.

- Spasm of the head and neck with pulling sensation and pain: Ren-24 Chengjiang, Du-20

Baihui, G.B.-21 Jianjing, T.B.-3 Zhongzhu.

- Headache with vomiting from alcohol consumption, dislike of hearing people talking: KI-

1 Yongquan, LU-7 Lieque, L.I.-4 Hegu.

- Eyes red and swollen, tears when exposed to wind: BL-2 Zanzhu, L.I.-4 Hegu, G.B.-41

Zulinqi, Xiaogukong.

- Spasm and contraction of the limbs, high fever, after invasion of Wind: LIV-1 Dadun,

L.I.-4 Hegu, LIV-2 Xiangjian, Shixuan.

POINTS OF THE DU MAI

DU-1

Chengjiang

DU-3

Yaoyangguan

DU-5 Xuanshen

DU-7 Zhongshu

DU-9 Zhiyang

DU-11 Shendao

DU-13 Taodao

DU-15 Yamen

DU-2 Yaoshu

DU-4 Mingmen

DU-6 Jizhong

DU-8 Jinsuo

DU-10 Lingtai

DU-12 Shenzhu

DU-14 Dazhui

DU-17 Naohu

DU-15 Yamen

DU-16 Fengfu

DU-19 Houding

DU-18 Qiangjian

DU-20 Baihui

DU-20 Baihui

DU-21 Qianding

DU-22 Xinhui

DU-23 Shangxing

DU-24 Shenting

DU-28 Yinjiao

DU-27 Duiduan

DU-26 Renzhong

DU-25 Suliao

. . .

DU-3 YAOYANGGUAN Lumbar Yang Gate

Location

On the lumbar region, on the posterior median line, in the depression below

the spinous process of L-4.

b) Actions

.Strengthens the lower back and legs.

.Tonifies Yang.

c) Indications

.Lower backache, sciatica, stiffness of lumbar region

.Impotence, white leukorrhoea.

d) Comments

Du-3 is very frequently used as a local point in lower back ache,

particularly if due to Kidney-Yang deficiency. It is also especially indicated

when the backache radiates to the legs. Besides strengthening the lower

back by tonifying Kidney-Yang, it also strengthens the legs, and is an

important point to use for weakness of the legs in Atrophy Syndrome.

DU-4 MINGMEN Gate of Life

Location

On the lumbar region, on the posterior median line, in the depression

below the spinous process of L-2.

b) Actions

.Tonifies Kidney-Yang and warms the Ming Men

.Tonifies the Yuan Qi

.Expels Cold

.Strengthens the Du Mai

.Strengthens the lower back

.Benefits Jing

.Clears the Shen

.Clears Heat

.Extinguishes interior Wind.

c) Indications

.Backache, dizziness, tinnitus, cold knees, feeling of cold in the

lower back, frequent-pale urination, tiredness

.Chilliness, cold knees and back, cold feet, pain from Cold

.Lower backache from Kidney deficiency

.Seminal emissions

.Depression, lack of will power, mental confusion

.Heat in the body

.Tremor of head, opisthotonos, epilepsy.

d) Comments

The Fire of Ming Men is closely linked to the Pre-Heaven Jing. The

Fire of the Ming Men is the physiological Fire of the body which

provides the warmth that is essential for all physiological processes of

the body and for all the internal organs. The Fire of the Ming Men is

already present from birth and, indeed, from conception.

Thus, the Fire of the Ming Men can be said to represent the Yang

aspect of the Pre-Heaven Jing, while the Pre-Heaven Jing proper

represents the Yin aspect. Du-4's alternative name, “Jing Gong”, i.e.

“Palace of Jing” clearly shows the connection of the Ming Men with

Jing, i.e. it is the Yang aspect of Jing.

The Fire of the Ming Men accumulates at the point Du-4 Mingmen on

the spine at conception, while the Pre-Heaven Jing concentrates at the

point Ren-4 Guanyuan, also at conception.

Du-4 is the most powerful point to strengthen Kidney-Yang and all the

Yang energies in general, especially if used with moxa. It tonifies and

warms the Fire of the Ming Men. It is therefore used for Kidney-Yang

deficiency with such symptoms as chilliness, abundant-clear urination,

tiredness, lack of vitality, depression, weak knees and legs, a Pale

tongue and a Deep-Weak pulse.

If this point is used with moxa, caution must be exercised, as it is a

very warming point. One must therefore make sure not only that

there is indeed a deficiency of Kidney-Yang, but also that there is

internal Cold. A person may suffer from deficiency of Kidney-

Yang, but also have some internal Heat somewhere else in the body

(e.g. Damp-Heat in the Intestines). In such a case, this point would

not be indicated as it would aggravate the Heat condition.

Du-4 also benefits the Yang aspect of the Kidney-Jing and is

indicated in all sexual disorders due to weakness of Jing, such as

impotence, premature ejaculation or nocturnal emissions.

Du-4 is very effective in strengthening the lower back and knees

and is indicated in chronic lower back ache deriving from

deficiency of Kidney-Yang.

Du-4 is specific to eliminate interior Cold deriving from Yang

deficiency. This could be in the Spleen, manifesting with chronic

diarrhoea, in the Bladder, manifesting with profuse-clear urination,

incontinence or enuresis, in the Intestines, manifesting with

abdominal pain, or in the Uterus, manifesting with dysmenorrhoea

or infertility.

The Du Mai has a strong influence on the Mind (Shen) because it

affects it in three different ways.

Firstly, the Du Mai emanates from the space between the kidneys

and is related to Jing (in particular, the Yang aspect of Jing). The

Jing is the foundation of Qi and Mind (Shen) and the residence of

Will Power (Zhi): a strong Jing, therefore, will create the basis for a

strong Mind and Will Power.

Secondly, the Du Mai flows through the heart and it therefore

affects the Mind through the Heart.

Thirdly, the Du Mai enters the Brain which, according to some

doctors, is the residence of the Mind (Shen). For these reasons, the

Du Mai and in particular Du-4 affects the Mind: it clears the Mind

and lifts moods and it is an important point to treat depression

occurring against a background of Kidney-Yang deficiency.

Interestingly, although Du-4 is a warming point, it can be used also

to clear Heat: however, I personally do not use this point in this

way.

Shen

Zhi

Shen

DU-11 SHENDAO Mind Way

Location

On the back, on the posterior median line, in the depression below the

spinous process of T-5.

b) Actions

.Strengthen the Heart and calms the Mind

.Clears Heat

.Extinguishes interior Wind.

c) Indications

.Sadness, anxiety, poor memory, palpitations, disorientation, timidity

.Fever, feeling of heat

.Epilepsy in children, lockjaw.

d) Comments

Du-11 is on the same level as BL-15 Xinshu, the Back-Shu point of the

Heart, and its action mostly extends to the Heart. It nourishes the Heart

and calms the Mind, and therefore treats depression, sadness, anxiety.

However, Du-11 also clears Heat and can therefore be used to clear Heart-

Heat or drain Heart-Fire.

DU-12 SHENZHU Body Pillar

Location

On the back, on the posterior median line, in the depression below the

spinous process of T-3.

b) Actions

Clears Lung-Heat

Extinguishes interior Wind

Calms the Mind and opens the Mind's orifices

Tonifies Lung-Qi

c) Indications

.Heat in the chest, cough, feeling of heat, breathlessness, thirst,

agitation

.Epilepsy in children, opisthotonos

.Manic behaviour, “seeing ghosts”, rage with desire to kill people

.Tiredness, weak voice, propensity to catching cold, allergic

rhinitis, asthma.

d) Comments

Du-12 has two distinct functions according to whether it is

reduced or reinforced. When used with reducing method it

eliminates interior Wind and calms spasms, convulsions and

tremors. It is also used for epilepsy. With reducing method, it also

clears Lung-Heat.

When used with reinforcing method, it tonifies Lung-Qi (it is at

the same level as the Back-Shu point of the Lungs BL-13 Feishu)

and generally strengthens the body. It is used to tonify the Lungs

and to strengthen the body after a debilitating chronic illness.

In my experience, Du-12 is also an important point to strengthen

the Lungs in allergic rhinitis and asthma: I use it to treat the Root

(Ben) in these two diseases to strengthen the Lungs and prevent

recurrence. For example, I use it in the autumn to prevent the

occurrence of seasonal allergic rhinitis in the Spring. When I use

Du-12 to strengthen the Lungs I always combine it with BL-13

Feishu.

The indication “desire to kill people” for this point is interesting. The

indication “desire to commit suicide” for BL-13 Feishu must be seen

in the context of the Po which is housed in the Lungs. The Po is a

physical soul with a centripetal movement, constantly materializing

and constantly separating into different constituent aspects.

The Po is in relation with gui, i.e. ghosts or spirits (of dead people).

The centripetal forces of Gui within the Po, constantly fragmenting

are, eventually, the germ of death.

It is therefore interesting that the three points related to the Lungs

(which house the Po), all aligned on the back, are indicated either for

desire to commit suicide or desire to kill, i.e. they are related to

thoughts of death. The indications are as follows:

- BL-13 Feishu: “desire to commit suicide”

- BL-42 Pohu: “three corpses flowing”

- Du-12 Shenzhu: “desire to kill people”.

DU-14 DAZHUI Big Vertebra

Location

On the posterior median line, in the depression below the spinous

process of C-7.

a) Nature

Meeting point of Du Mai with all Yang channels.

Point of the Sea of Qi.

b) Actions

.Clears Heat

.Releases the Exterior and expels exterior Wind

.Regulates Ying and Wei Qi

.Extinguishes interior Wind

.Clears the Mind

.Tonifies Yang.

c) Indications

.Fever, feeling of heat

.Aversion to cold, fever, body aches, occipital headache and

stiffness

.Invasion of external Wind, aversion to cold, fever, slight sweating

.Epilepsy

.Depression, tiredness, poor memory, poor concentration

.Chilliness, profuse-pale urination.

d) Comments

Du-14 can have opposite effects according to the needling

method used. When used with a reducing method it releases the

Exterior and is used in exterior attacks of Wind-Heat: this point

will release the Exterior and eliminate Wind-Heat. It is

specifically used for invasions of Wind-Heat as opposed to

Wind-Cold. It also regulates Ying and Wei Qi when the person

has been attacked by exterior Wind and is sweating.

When needled with reducing method, Du-14 also extinguishes

interior Wind and clears interior Heat, and can be used in

virtually any pattern of interior Heat.

If used with reinforcing method and, in particular, with direct

moxa, Du-14 tonifies the Yang and can be used in any interior

pattern of Yang deficiency. In particular, it tonifies Heart- and

Kidney-Yang.

Since it is also the meeting point of all the Yang channels which

transport clear Yang upwards to the head, it is a point of the Sea

of Qi, and the Du Mai enters the brain, Du-14 can also clear the

Mind and stimulate the brain when the person is depressed and

confused.

DU-16 FENGFU Wind Palace

Location

On the back of the neck, 1 cun directly above the midpoint of the posterior

hairline, directly below the external occipital protuberance, in the depression

between the trapezius muscle of both sides.

a) Nature

Point of the Yang Wei Mai.

Point of the Sea of Marrow.

Window of Heaven point.

One of Sun Si Miao's Ghost points.

Point of the Eye System.

b) Actions

.Extinguishes interior Wind

.Expels exterior Wind

.Nourishes Marrow and benefits the Brain

.Calms the Mind and opens the Mind's orifices.

c) Indications

.Opisthotonos, aphasia from Wind-stroke, Wind-stroke, hemiplegia

.Aversion to cold, fever, body aches, occipital stiffness and headache

.Headache, dizziness, tinnitus, blurred vision

.Manic behaviour, desire to commit suicide, sadness, fear.

d) Comments

Du-16 eliminates both exterior and interior Wind. It can therefore be

used for exterior attacks of Wind-Cold or Wind-Heat, as well as for

patterns of interior Wind, such as in Wind-stroke, epilepsy or severe

giddiness.

Its capacity in eliminating Wind in general makes it an important

point to relive headaches from Liver-Yang rising, Liver-Wind,

Liver-Fire and acute headaches from exterior Wind. Its action in

treating headaches is also partly due to this point's being a point of

the Eye System which emerges from the Brain at Du-16 Fengfu.

Du-16 is a point of the Sea of Marrow. Marrow fills up the brain,

and this point can clear the Mind and stimulate the brain.

BAIHUI DU-20 Hundred Meetings

Location

On the head, 5 cun directly above the midpoint of the anterior hairline.

a) Nature

Meeting point of Du Mai with Bladder, Gall-Bladder, Triple Burner and

Liver channels.

Point of the Sea of Marrow.

b) Actions

•Extinguishes interior Wind

•Subdues Liver-Yang

•Raises Yang

•Benefits the Brain and the sense organs

•Lifts the Mind

•Promotes resuscitation.

c) Indications

•Wind-stroke, hemiplegia, opisthotonos, loss of consciousness,

epilepsy

•Headache, dizziness, tinnitus, blurred vision

•Prolapse of internal organs (stomach, uterus, bladder), prolapse of

anus

•Dizziness, brain noise, tinnitus, poor memory, nasal obstruction, nasal

discharge, nosebleed, blurred vision

•Depression

•Loss of consciousness.

d) Comments

Du-20 is at the vertex of the head, the place of maximum

potential of energy and also the convergence area of Yang

channels. For this reason, it has a dual function as it can either

expel Excess Yang from the head or promote the rising of Yang to

the head.

Du-20's action in extinguishing interior Wind and subduing Liver-

Yang is related to its first function. For this reason, this is an

important point for headaches from Liver-Yang rising or Liver-

Wind.

Du-20 is a meeting point of many Yang channels which carry

clear Yang to the head: it therefore has a powerful effect in

stimulating the ascending of Yang. When used with direct moxa,

it stimulates the ascending of clear Qi to the head, and is therefore

used for prolapse of the internal organs, such as stomach, uterus,

bladder, anus or vagina. It is especially indicated for prolapse of

anus which lies on the Du Mai's pathway. Du-20 is effective not

only in actual prolapses but also for incontinence of urine, very

frequent urination and generally sinking of Qi with a feeling of

bearing down in the lower abdomen.

When using this point with moxa to raise the Yang, caution

must be exercised to make sure that there are no Heat

symptoms at all. Also, this point should not be stimulated with

moxa if the person suffers from high blood pressure.

This point's lifting action on Yang has a mental effect in that it

promotes the rise of clear Yang to the Brain and the Mind. In

my experience, Du-20 has a powerful effect in lifting

depression and clearing of the mind.

Finally, it promotes resuscitation when the person is

unconscious, especially combined with Renzhong Du-26 and

Neiguan P-6.

DU-24 SHENTING Mind Courtyard

Location

On the head, on he midline, 0.5 cun directly above the midpoint of

the anterior hairline.

a) Nature

Meeting point of Du Mai and Stomach channels.

b) Actions

.Calms and lifts the Mind, opens the Mind's orifices

.Extinguishes internal Wind

.Benefits the nose

.Brightens the eyes.

c) Indications

.Manic-depression, depression, anxiety, poor memory, insomnia

.Opisthotonos, epilepsy, dizziness, vertigo

.Clear nasal discharge (allergic rhinitis), nasal congestion,

nosebleed

.Lachrymation, blurred vision.

d) Comments

The most important aspect of Du-24’s energetic action is its

downward movement: it makes Qi descend and subdues rebellious

Yang. This is a very important and powerful point to calm the

Mind. It is frequently combined with G.B.-13 Benshen for severe

anxiety and fears.

An important feature of this point which makes it particularly

useful is that it can both calm and lift the Mind: therefore it used

not only for anxiety and insomnia but also for depression and

sadness. It is also used in psychiatric practice for schizophrenia.

The name of this point refers to its strong influence on the Mind

and Spirit. The courtyard was traditionally considered to be a very

important part of the house as it was the one that gave the first

impression to visitors; it is the entrance. Thus, this point could be

said to be the “entrance” to the Mind and Spirit and its being a

courtyard, highlights its importance.

HERBAL THERAPY

Also the marrow of goat and beef strengthen the Du

Mai (Li Shi Zhen includes also dog meat as a

strengthening food for the Du Mai).

Lu Rong Cornu Cervi parvum enters the Du Mai,

generates Jing, nourishes Marrow and Blood, benefits

Yang and strengthens sinews and bones.

Other herbs that enter the Du Mai include:

Qiang Huo Radix et

Rhizoma Notopterygii Cang Er Zi Fructus

Xanthii

Du Huo Radix Angelicae

pubescentis

Fang Feng Radix

Ledebouriellae sesloidis

Jing Jie Herba seu Flos

Schizonepetae tenuifoliae

Fu Zi Radix Aconiti carmichaeli

praeparata

Xi Xin Herba Asari

cum radice

Gao Ben Rhizoma et Radix

Ligustici sinensis

Wu Tou Radix Aconiti

carmichaeli

REN MAI 任 脉

THE DIRECTING VESSEL

Giovanni Maciocia

任 To direct

壬“ren”, phonetic

妊 Conception

女 Woman

Person

REN MAI - PATHWAY

The Ren Mai is called the “Sea of the Yin channels”

as it exerts an influence on all the Yin channels of

the body.

The Ren Mai is of paramount importance for the

reproductive system of both men and women, but

particularly women, as it regulates:

Puberty

Menstruation

Fertility

Conception

Pregnancy

Childbirth

Menopause

Flows through the uterus down to Ren-1

Huiyin where the superficial pathway starts.

It originates from the space between the Kidneys (like the Du

and Chong Mai)

Ren-1

.

Chapter 60 of the “Simple Questions” describes the pathway of the Ren

Mai:

It then comes up to edge of the hair (superior edge

of pubic bone), it enters the abdomen and reaches

Ren-4 Guanyuan.

“The Ren Mai starts below the point Ren-3 Zhongji.

It then goes up to the throat, circles around the chin,

reaches the face and enters the eyes.”

Li Shi Zhen describes the pathway of the Luo channel of the Ren Mai:

“The Luo channel of the Ren Mai separates from

Ren-15 Jiuwei and it spreads over the abdomen.”

The Ren Mai and the Du Mai are like to halves of one channel, one

Yin, the other Yang. They both originate from the space between the

kidneys, both flow through the uterus, both flow to Ren-1, both

connect with the heart. They are therefore an important way in which

the Kidneys and Heart communicate with each other in physiology.

The coordination of Ren and Du is also essential for the menstrual

cycle to occur. In fact, the menstrual cycle is like a tide, or rather two

tides, one of Kidney-Yin, the other of Kidney-Yang. The Ren

represents Kidney-Yin and the Du Kidney-Yang and the menstrual

cycle occurs because these two vessels flow through the Uterus

Du Mai Ren Mai

HEART

KIDNEYS

UTERUS

Ren Mai

Du Mai

DU MAI – REN MAI - UTERUS

Bao Mai

Bao Luo

THE FOUR PHASES OF THE MENSTRUAL CYCLE

Phase 1: Period Phase 2: Post-menstrual Phase 3: Mid-cycle Phase 4: Pre-menstrual

Transformation

from Yang to Yin Transformation

from Yin to Yang

YANG

YIN

36.2

36.5

37.1

Normal BBT chart

EBB AND FLOW OF YIN-YANG IN THE MENSTRUAL CYCLE

HEART

KIDNEY

UTERUS

Bao Mai

Bao Luo

= Chong Mai

= Ren/Du Mai

Du Mai Ren Mai

Du and Ren control the ebb and flow of Yin-Yang in the menstrual

cycle. The two Qiaos help the balance of Yin-Yang while the two

Weis control the connection of Yin-Yang. They have a secondary

role in the regulation of the menstrual cycle as they do not flow

through the uterus.

Ren-1

Brain

CLINICAL APPLICATIONS OF THE REN MAI

1) NOURISHING YIN

The Ren Mai can be used to nourish all the Yin of the body. Its name

establishes a correspondence and symmetry with the Du Mai:

The Du Mai

“governs” all the

Yang channels

The Ren Mai

“directs” all the Yin

channels.

In this context it is particularly useful to nourish Yin in women after

menopause as the Ren Mai controls the Uterus and determines the 7-year

life cycles of women.

It can nourish Blood and Yin to reduce the effects of Empty-Heat

symptoms deriving from Yin deficiency.

The Ren Mai can therefore be used for such menopausal symptoms as:

Night-sweating, hot flushes, feeling of heat, mental restlessness, anxiety,

dry mouth at night, dizziness, tinnitus, insomnia

However, menopausal symptom also occur against a background of KI-

Yang Xu

The opening and coupled points (LU-7 Lieque and KI-6 Zhaohai) are

combined with Ren-4 Guanyuan or Ren-7 Yinjian if the Yin deficiency is

pronounced.

The Ren Mai can also be used for Yin deficiency in general.

In such cases, the opening and coupled points of the vessel (LU-7

and KI-6) can be combined with Ren-17 Shanzhong and Ren-4

Guanyuan.

asthma

a dry cough

a dry throat

night-sweating

dizziness

tinnitus

Lung- and Kidney-Yin deficiency

In such cases, the opening and coupled points of the vessel (LU-7 and

KI-6) can be combined with Ren-15 Jiuwei and Ren-4 Guanyuan.

dry throat at night

palpitations

anxiety

insomnia

night-sweating

dizziness

tinnitus

Heart- and Kidney-Yin deficiency

Liver- and Kidney-Yin deficiency

dry eyes

blurred vision

headaches

irritability

dry throat

night-sweating

dizziness

tinnitus

In such cases, the opening and coupled points of the vessel (LU-7 and

KI-6) can be combined with Ren-4 Guanyuan and Ren-3 Zhongji.

Stomach- and Kidney-Yin deficiency

dry mouth

night-sweating

dizziness

tinnitus

In such cases, the opening and coupled points of the vessel (LU-7 and

KI-6) can be combined with Ren-12 Zhongwan and Ren-4 Guanyuan.

The waxing and waning of Kidney-Yin and Kidney-Yang in the

menstrual cycle takes place through the Ren and Du Mai both of

which flow through the Uterus. Therefore, the Ren Mai is

responsible for the waxing and waning of Kidney-Yin during the

monthly cycle.

In the second half of the cycle (the luteal phase under the

control of progesterone), Kidney-Yin decreases and Kidney-

Yang increases.

In the first half of the cycle (the follicular phase under the

control of oestrogen), Kidney-Yin increases and Kidney-Yang

decreases.

So in the first half of the cycle the Ren Mai is predominant and

in the second half the Du Mai is predominant. As both Vessels

originate from the Uterus and the Du Mai flows into the brain,

they could be seen as the Chinese medicine equivalent of the

Western hypothalamus-pituitary-ovarian axis which controls

ovulation and the menstrual cycle

The Ren Mai regulates the Uterus in women, so that it is

responsible for puberty, menstruation, fertility, conception,

pregnancy, childbirth and menopause.

This means that the Ren Mai can be used for a very wide variety of

gynaecological problems:

Problems of puberty, infertility, menstrual irregularities (late periods,

early periods, long periods, short periods, no periods, irregular periods,

scanty periods, heavy periods), pre-menstrual syndrome, problems of

pregnancy, problems after childbirth, menopausal problems, polycystic

ovary syndrome, endometriosis, myoma.

2) REGULATES THE UTERUS

The Chong Mai is the main vessel to use for painful periods,

especially when they are caused by Blood stasis. However, the Ren

Mai can be used for painful periods caused by Qi stagnation or

Dampness.

I can say that in my practice I nearly always use either the Ren or

Chong Mai in all gynaecological problems and there is some degree of

overlap between the two Vessels.

There is often an overlap in the pathology of the Ren Mai and Chong Mai. I

do not use both vessels at the same time.

A good method is to use the Ren Mai in phases 2 and 3 and the Chong Mai

in phases 4 and 1.

The Ren Mai has an important influence on the external and internal

genitalia in women. It can treat any genital problems, whatever the

underlying pattern, e.g. vaginitis, vulvitis, vulvodynia, pain on

intercourse, itching of genitals.

In such cases I use LU-7 on the right, KI-6 on the left, plus Ren-3

Zhongji, or Ren-2 Qugu or Ren-1 Huiyin. Possibly also SP-9

Yinlingquan to resolve Dampness and/or LIV-5 Ligou if the Liver

channel is involved.

HYPOTHALAMUS

PITUITARY

FOLLICLE CORPUS LUTEUM

UTERUS

Oestrogen Progesterone

Gonadotropin releasing hormone GnRH

FSH LH

DU MAI

REN MAI

Pituitary Hypotha lamus

Ovary

REN-1

Uterus

3) REGULATION OF LIFE CYCLES

The implication of these life cycles is that the Ren Mai can be used

to help a person during the transition from one phase of life to

another. For example, I nearly always use the Ren Mai in

menopausal women to help the transition from the reproductive to

the menopausal age.

Chapter 1 of the “Su Wen” describes the 7-year life cycles for women

and the 8-year cycles for men: these cycles describe the waxing and

waning of Qi in the course of our life. Men reach a peak at 32 and

women at 28; men’s Qi and Jing decline from 56 onwards and women’s

from 49 onwards.

These life cycles essentially describe what we would call

hormonal changes in Western medicine. Although these cycles

are governed by 8 years for men and 7 years for women

respectively, such values should not be interpreted too rigidly as,

in practice, there can obviously be variation from such values.

Similarly, the Ren Mai can be used to help girls during

puberty in the transition to the reproductive age. For

example, the Ren Mai can be used for primary

amenorrhoea.

Another example of use of the Ren Mai in times of

transition is after childbirth or during pregnancy.

4) MOVE QI IN THE LOWER BURNER AND UTERUS

Abdominal masses in general are called Ji-Ju in which Ji refers to actual,

fixed masses from Blood stasis and Ju to moving masses that come and go

from Qi stagnation.

In women, abdominal masses are called Zheng-Jia in which Zheng

(equivalent to Ji) refers to actual masses from Blood stasis and Jia

(equivalent to Ju) to masses that come and go from Qi stagnation.

Nan Jing, chapter 29

“The Ren Mai's diseases consist in internal stagnation which, in men,

can give rise to the 7 kinds of Hernial and Genito-Urinary Disorders

[Shan] and, in women, to abdominal masses from Qi stagnation, [i.e.

Jia and Ju].”

The Ren Mai moves Qi in the Lower Burner and Uterus so that it can

be used for abdominal masses but especially those deriving from Qi

stagnation rather than from Blood stasis. In men, it is used for Hernial

and Genito-Urinary Disorders (Shan).

In general, the Ren Mai can be used in cases of gynaecological problems

due to stagnation of Qi. In these cases one must use the opening and

coupled points (LU-7 and KI-6) to move Qi.

All classics confirm that the Ren Mai is indicated for abdominal

masses from Qi stagnation, i.e. the Jia or Ju types.

When used to move Qi, the opening and coupled points

(LU-7 and KI-6) are frequently combined with Ren-6

Qihai.

The Qi-moving action of these two points is also due to their

intrinsic nature as LU-7 Lieque promotes the downward flow of

Lung-Qi towards the Kidneys. This point provides a powerful

stimulation and movement of Qi, which in turn moves Blood.

The coupled point KI-6 Zhaohai tonifies the Yin and has a strong

upward-flowing movement, hence the use of both points sets the Qi

in motion like a wheel and resolves stagnation, especially when

they are used unilaterally and crossed over. LU-7

KI-6

The sphere of action of the Ren Mai extends not only to the Lower Burner, but

also to the Middle and Upper Burner. It can in fact also be used to stimulate

the descending of Lung-Qi and the Kidney's receiving of Qi.

5) PROMOTE THE DESCENDING OF LUNG-QI AND THE KIDNEY'S

RECEIVING OF QI

The Ren Mai is good to treat asthma and especially allergic asthma (with

LU-7 Lieque, KI-6 Zhaohai, Ren-4 Guanyuan and Ren-17 Shanzhong).

• LU-7 Lieque on one side and KI-6 Zhaohai on the other to open

the Ren Mai and tonify Lungs and Kidneys

• Ren-17 Shanzhong to promote the descending of Qi and to tonify

Qi

• BL-13 Feishu and Du-12 Shenzhu to tonify the Lung’s Wei-Qi

system

• BL-23 Shenshu and Ren-4 Guanyuan to tonify the Kidney’s Wei-

Qi system

I use it for asthma from Lung and Kidney deficiency in people with a

tendency to Yin deficiency.

It is especially good for allergic asthma because this is due to a

constitutional deficiency of the Lung’s and Kidney’s Defensive-Qi

systems and therefore the opening and coupled points of the Ren Mai

tonify these two organs. To treat allergic asthma one can use the

following combination:

The Ren Mai is very important for the correct distribution of fluids in

the abdomen, hence it can be used in oedema and urinary problems.

6) PROMOTE THE TRANSFORMATION, TRANSPORTATION AND

EXCRETION OF FLUIDS

Oedema is usually caused by:

The Lungs not diffusing and descending Qi and

transforming fluids

Spleen-Yang not transforming and moving fluids

Kidney-Yang not moving, transforming and excreting

fluids.

By using the Ren Mai we can send the Qi down by using LU-7 Lieque

and stimulate the Kidneys by using KI-6 Zhaohai, together with points

such as Ren-9 Shuifen, Ren-5 Shimen and BL-22 Sanjiaoshu.

Many points on the Ren Mai stimulate the metabolism of fluids by the

Triple Burner

- Ren-17 Shanzhong: acts on the Upper Burner and promotes diffusing and

descending of Lung-Qi

- Ren-12 Zhongwan: acts on the Middle Burner and promotes

transformation and transportation of fluids by the Spleen and Stomach.

The most important points that have an effect on the metabolism of

fluids are as follows:

- Ren-9 Shuifen: acts primarily on the Middle Burner and promotes

transformation and transportation of fluids by the Lungs, Spleen and

Kidneys.

- Ren-5 Shimen: acts on the Lower Burner (it is the Front-Mu point of

the Triple Burner) and promotes transformation, transportation and

excretion of fluids in the Lower Burner.

The main points that activate the movement of Qi of the Triple

Burner are actually not on the Triple Burner channel but on the Ren

Mai. They are as follows:

Ren-17 Shanzhong for

the Upper Burner

Ren-12 Zhongwan

Ren-9 Shuifen

Ren-6 Qihai

Ren-5 Shimen

Ren-3 Zhongji

LOWER

BURNER

MIDDLE

BURNER

.

. . . . .

The use of LU-7 Lieque in the context of the Ren Mai also stimulates

the Bladder to excrete fluids. This reflects the close relationship

between the Lungs and the Bladder. For this reason, the Ren Mai is

frequently used for urinary problems in women from stagnation in

the Lower Burner or Qi sinking.

The Ren Mai and Urination

Urinary problems deriving from Qi deficient and sinking manifest with

frequency of urination either without pain or with only very slight pain,

slight incontinence of urine, and a bearing-down feeling in the lower

abdomen.

Urinary problems deriving from Qi stagnation manifest with frequency

and difficulty in urination, a feeling of distension in the hypogastrium, and

a slight ache before urination.

To affect urination, use the opening and coupled points of the Ren Mai (LU-

7 and KI-6) together with Ren-3 Zhongji coupled with Du-20 Baihui for

sinking of Qi or with Du-26 Renzhong for Qi stagnation

LU-7 Lieque stimulates the Bladder to excrete fluids.

LU-7

KI-6

Du-20

Ren-3

Du-26

Sinking of Qi

Qi stagnation

.

.

. .

.

7) THE REN MAI AND THE MALE GENITAL SYSTEM

The Ren Mai flows at the front of the body over the

external genitalia and therefore the testicles and penis

in men.

i. The penis

The Ren Mai represents the influence of Kidney-Yin on the penis and

testis: it is the channel through which Kidney-Yin provides Jing. Thus,

the Ren Mai represents the Yin aspect of Jing (and the Du Mai the Yang

aspect of Jing).

The Ren Mai can be used to treat problems of the male genitalia

occurring against a background of Kidney-Yin deficiency.

It can be postulated that, in men, the prostate is the organ

equivalent to the Uterus in women. Therefore the three vessels that

arise in the lower abdomen, the Du, Ren and Chong Mai, all flow

through a man’s the prostate on their way down to Ren-1 Huiyin.

ii. The prostate

PROSTATE

Ren-1 Huiyin

When considering the physiology and pathology of the prostate

gland in Chinese medicine, the seminal vesicles should be

assimilated with the prostate.

Just as the ovaries in women are related to the Kidney-Jing, so

is the prostate in men.

Just as the Du and Ren Mai in women represent the Yang and

Yin aspect of the menstrual cycle, in men these two vessels

both influence the prostate and the production of seminal

fluid.

PROSTATE

SEMINAL

VESICLE

Jointly with the seminal vesicles, the prostate produces about

90% of the seminal fluid.

A deficiency of Kidney-Yin and of the Ren Mai may cause

abnormalities of the sperm such as a reduced sperm count.

In the presence of a background of Kidney-Yin deficiency, this can be

boosted by using the Ren Mai with its opening and coupled points (LU-

7 on the left and KI-6 on the right) together with Ren-4 Guanyuan and

KI-13 Qixue.

Sperm is a direct manifestation of Jing and, as such, it is part of the

Yin part of Jing (and therefore the Ren Mai); Kidney-Yin and the Ren

Mai provide the male genital system with Jing and they therefore play

an important role in the production of sperm.

The Ren and Du Mai are like two branches of one channel, one

Yang, the other Yin, both originating from the same place and

both flowing to the Heart. They could really be seen as one

channel with a Yang part and a Yin part.

8) COMBINATION OF REN AND DU MAI POINTS

Finally, as these two vessels both flow upwards to the head and the

Du Mai flows into the brain, combining their points also has a very

powerful and important mental effect which can be either lifting or

calming.

Therefore the balancing of points from the Du and Ren Mai is

a very important aspect of Yin-Yang and, as the Du Mai is in

the back and the Ren Mai in the front, of Back-Front

balancing and a very effective treatment in practice.

The following are examples of combination of points from the Ren and Du

Mai:

- Du-14 Dazhui and Ren-4 Guanyuan, both with direct moxa cones, to

tonify the Heart- and Kidney-Yang and Yang Qi in general. Du-14 warms

all the Yang channels and the Heart, while Ren-4 tonifies and warms

Kidney-Yang which is the foundation for all the Yang energies of the

body.

- Du-16 Fengfu and Ren-24 Chengjiang to treat occipital headache

- Du-19 Houding and Ren-15 Jiuwei to calm the Spirit. Du-19 calms the

Spirit while Ren-15 calms the Spirit and nourishes the Heart. This

combination has a powerful calming effect. Ren-15 will also relieve anxiety

manifesting with a feeling of oppression in the chest.

- Du-20 Baihui and Ren-15 Jiuwei calms the Spirit and lifts mood. It is an

excellent combination for mental depression with anxiety. This combination

can simultaneously calm the Spirit and improve mood.

- Du-20 Baihui and Ren-12 Zhongwan tonify the Stomach and Spleen

and lift mood. This treats depression with Stomach and Spleen

deficiency.

- Du-20 Baihui and Ren-4 Guanyuan calm the Spirit, nourish the Kidneys

and strengthen Yuan Qi. This relieves depression by nourishing Kidney-

Yin and strengthening the Yuan Qi. It is also used for excessive menstrual

bleeding caused by deficiency and sinking of Qi.

- Du-20 Baihui and Ren-6 Qihai tonifies and raises Qi: this combination

is excellent in cases of prolapse or sinking of Qi. It also has a powerful

mood-lifting effect in depression.

- Du-20 Baihui and Ren-3 Zhongji treat urinary problems due to

deficiency and sinking of Qi in the Bladder manifesting with frequency of

urination without pain or with only very slight pain, slight incontinence of

urine, and a bearing-down feeling in the lower abdomen.

- Yintang and Ren-4 Guanyuan calm the Spirit and root Qi in the

Lower Burner by nourishing the Kidneys and strengthening the Yuan

Qi. This combination is better for insomnia.

- Du-24 Shenting and Ren-4 Guanyuan calm the Spirit by nourishing

Kidney-Yin and strengthening the Yuan Qi. It is suitable for severe

anxiety with Kidney deficiency. It is particularly indicated for anxiety as

it roots Qi in the Lower Burner and draws it downwards away from the

head and the Heart where it harasses the Mind.

- Du-24 Shenting and Ren-15 Jiuwei calm the Mind and nourish the Heart. It

is used for depression, anxiety and mental-emotional problems with

Deficiency.

- Du-26 Renzhong and Ren-3 Zhongji move Qi in the Bladder. This is used

for Qi stagnation in the Bladder causing frequent and difficult urination,

hypogastric distension and a slight ache before urination.

SUMMARY OF REN MAI CLINICAL APPLICATIONS

9) THE PULSE OF THE REN MAI

The same text describes another pulse quality of the Ren Mai:

The pulse of the Ren Mai is Long, Tight, Fine on both Front positions,

extending down to Middle position

“When the pulse feels like pellets horizontally on [both] Front position, it

indicates [a pathology of] the Ren Mai. There will be finger-shaped Qi

masses in the abdomen harassing the heart upwards, inability to bend

forward or backward and tenseness [of the abdomen].”

Pulse Classic Mai Jing

“When the pulse is Tight, Fine, Full and Long on [both] Middle

positions, it indicates [a pathology of] the Ren Mai. There will be

abdominal pain from the umbilicus to the pubis, pain in the genitals.

Treat the point 3 cun below the umbilicus [Ren-4 Guanyuan].”

a) PATHOLOGY

Su Wen, chapter 60

“Diseases of the Ren Mai cause the 7 kinds of Hernial and Genito-

Urinary disorders [Shan] in men and abdominal masses [from Qi

stagnation] in women [Jia and Ju].”

Nan Jing, chapter 29

“The Ren Mai's diseases consist in internal stagnation which can give rise

to, in men, the 7 kinds of Hernial and Genito-Urinary Disorders [Shan]

and, in women, to abdominal masses [from Qi stagnation, i.e. Jia of

Zheng-Jia and Ju of Ji-Ju].”

CLASSICAL INDICATIONS

Jia Yi Jing, AD 282

“Diseases of the Ren Mai include the seven types of Hernial and Genito-

Urinary Disorder [Shan] in men and abdominal masses [from Qi

stagnation] in women [of the Jia and Ju type].”

Mai Jing, AD 280

“When the Ren Mai is diseased there are accumulations [in the abdomen]:

in men, the seven kinds of Hernial and Genito-Urinary Disorders [Shan];

in women, abdominal masses [from Qi stagnation] of the Jia or Ju type.”

“If both Front-position pulses feel like small pellets, this is a Ren Mai

pulse. This causes finger-shaped accumulations of Qi in the abdomen

which may surge up towards the heart. There will be inability to bend

the body and rigidity. If the pulse feels Tight, Fine, Full and Long up to

the Middle Position, it is a Ren Mai pulse. There will be umbilical pain

radiating downwards to the pubic bone and a severe pain in the

genitals.”

“Haemorrhoids, swelling of the anus, dysentery, coughing of sputum

with blood, toothache, swollen throat, difficult urination, chest and

abdominal pain, difficulty in swallowing with choking sensation,

aphasia after labour, backache, cold abdomen, dead foetus that cannot

be expelled with Qi rising to the diaphragm.”

Golden Mirror of Medicine (Yi Zong Jin Jian, 1742)

Li Shi Zhen gives the indications of the Luo channel of the Ren Mai:

“When the Luo channel of the Ren Mai is full there is pain on the skin

of the abdomen; when it is empty there is itching over the abdomen.”

Zhang Jing Yue therefore clarifies specifically that the abdominal masses in

Ren Mai pathology are of the non-substantial type from Qi stagnation. In

fact, there are two terms to indicate “abdominal masses”, i.e. Zheng-Jia and

Ji-Ju : in which “zheng” and “ji” indicate actual, fixed masses (from Blood

stasis, which I call “Blood Masses”), and “Jia” and “Ju” indicate non-

substantial abdominal masses that come and go (from Qi stagnation, which I

call “Qi Masses”). Generally, Zheng-Jia refers to abdominal masses in

gynaecological conditions, whereas Ji-Ju occur in both men and women.

Lei Jing

“Diseases of the Ren Mai include the 7 types of Hernial and Genito-Urinary

Disorders [Shan] in men and leucorrhoea and abdominal masses [from Qi

stagnation, i.e. Jia-Ju] in women . . . it is white-red leucorrhoea. These are

abdominal masses of the Jia type [as in Zheng-Jia] and of the Ju type [as in

Ji-Ju].”

The “Gatherings from Eminent Acupuncturists” (Zhen Jiu Ju Ying, 1529) lists the following

symptoms and signs for the Ren Mai (using LU-7 Lieque and KI-6 Zhaohai) indicating in

brackets the organ involved:

Diarrhoea with cold pain (Spleen)

Stabbing abdominal pain (Spleen)

Pain in heart region and abdomen (Spleen)

Heart pain during an acute Warm disease

(Spleen) Abdominal pain from Blood lumps in women

(Liver)

Retention of dead foetus (Liver)

Hypochondrial lump and pain (Liver)

Feeling of heaviness and pain of the throat

(Stomach)

Chord-like mass beside the umbilicus

(Stomach)

Stagnation of food, not descending (Stomach)

Inability to digest rice and grains (Spleen)

Incessant vomiting (Spleen, Stomach)

Swelling, pain and abscess of breast (Stomach)

Warm disease (Wen Bing) not abating (Gall-

Bladder)

Hypochondrial lump in men from alcoholism

(Stomach and Liver)

Blood clots in women (Liver and Kidneys)

Post-partum backache (Kidneys)

Post-partum psychosis (Heart)

Post-partum aphasia (Pericardium)

Blood in urine (Small Intestine)

Difficult urination (Bladder)

Constipation (Large Intestine)

Blood in stools (Large Intestine)

Epigastric and abdominal pain (Heart and

Stomach)

Lumps (Heart and Stomach)

Feeling of heaviness and pain of teeth

(Stomach and Large Intestine)

Spitting of pus and blood (Lungs)

Coughing with cold phlegm (Lungs)

Borborygmi (Large Intestine)

Itchy, painful and bleeding haemorrhoids

(Large Intestine)

Spasm and pain in the small intestine (Small

Intestine)

REN-1 HUIYIN Meeting of Yin

POINTS OF THE REN MAI

REN-2 QUGU Curved

Bone

REN-3 ZHONGJI Middle

Pole

REN-4 GUANYUAN

Gate to the Yuan Qi

REN-8 SHENQUE Spirit Palace

REN-7 YINJIAO Yin Crossing

REN-6 QIHAI Sea of Qi

REN-5 SHIMEN Stone Door

. . . .

REN-9 SHUIFEN Water Separation

REN-13 SHANGWAN Upper Epigastrium

REN-10 XIAWAN Lower Epigastrium

REN-11 JIANLI Building Mile

REN-12 ZHONGWAN Middle of Epigastrium

REN-14 JUQUE Great Palace

REN-15 JIUWEI Dove Tail

REN-16 ZHONGTING Central Courtyard

REN-19 ZIGONG Purple Palace

REN-18 YUTANG Jade

Hall

REN-22 TIANTU Heavenly

Prominence

REN-24 CHENGJIANG Container of

Fluids

REN-21 XUANJI Jade Pivot

REN-17 SHANZHONG Middle of Chest

. REN-23 LIANQUAN

Corner Spring .

REN-20 HUAGAI

Magnificent Canopy

. .

.

REN-3 ZHONGJI Middle Pole

Location

On the midline of the lower abdomen, 4 cun below the umbilicus, 1 cun

superior to the pubic symphysis.

a) Nature

Front Mu point of the Bladder.

Meeting point of Ren Mai, Spleen, Liver and Kidneys channels.

Meeting point of the 3 Yin Muscle channels of the leg.

b) Actions

.Resolves Dampness from the Lower Burner

.Promotes the Bladder function of Qi transformation

.Benefits the Uterus and regulates menstruation

.Strengthens the Kidneys and nourishes the Jing.

c) Indications

.Genital itching, pain in the genitals, excessive vaginal discharge,

Hernial and Genito-Urinary Disorders (shan)

.Retention of urine, frequent urination, dark urine, pain on urination

.Infertility, irregular periods, amenorrhoea, excessive uterine bleeding,

abdominal masses in women (Zheng Jia), retention of placenta,

retention of lochiae, persistent lochial discharge

.Lower backache, dizziness, tinnitus, weak knees, deficiency of Yuan

Qi.

d) Comments

Ren-3 is an important point for genito-urinary problems. It is the

main point to affect the Bladder and its function of Qi

transformation. It can therefore be used for any urinary problem,

particularly acute ones. It is more frequently used with reducing

method in Excess patterns. However, it can also be used with

reinforcing method to strengthen the Bladder.

This point is specific to resolve Damp-Heat from the Bladder and

is used for such symptoms as pain and burning on urination and

interrupted flow of urine. It clears Heat from the Bladder and is

usually combined with some distal points for such symptoms as

fever, burning on urination and blood in the urine. To treat these

problems, it is often combined with SP-6 Sanyinjiao, SP-9

Yinlingquan or LIV-5 Ligou, depending on the presenting pattern.

Ren-3 also affects the Uterus and menstruation and it can be used

in many menstrual irregularities both to consolidate the

strengthen the Ren Mai and to invigorate Blood in the Uterus for

such problems as painful periods, retention of placenta,

abdominal masses, etc.

REN-4 GUANYUAN Gate to the Original Qi

Location

On the midline of the lower abdomen, 3 cun below the umbilicus, 2

cun superior to the pubic symphysis.

a) Nature

Front Mu point of the Small Intestine

Meeting point of Ren Mai, Spleen, Liver and Kidneys channels.

Meeting point of the Ren and Chong Mai.

b) Actions

Nourishes Blood and Yin

Strengthens the Kidneys

Strengthens the Uterus and regulates menstruation

Benefits Yuan Qi

Benefits the Bladder

Consolidates Ren and Chong Mai

Strengthens the Kidney's receiving of Qi

Roots the Shen and the Hun

Subdues rebellious Qi in the Chong Mai

Regulates the Small Intestine

c) Indications

.Lower backache, weak knees, dizziness, tinnitus, feeling of

cold in the back, dark face, frequent urination, impotence

.Infertility, cold sensation in the vagina, amenorrhoea, bleeding

in pregnancy, persistent lochial discharge

.Retention of urine, dark urine, painful urination, blood in the

urine

.Feeling of cold in the lower abdomen, Running Piglet

Syndrome, abdominal fullness, umbilical pain

.Diarrhoea, undigested food in the stools, incontinence of stools

in the elderly

.Cough, coughing of blood, breathlessness

.Fear, fright, insomnia.

d) Comments

Ren-4 is an extremely important point. It is one of the most powerful

points to tonify Qi and Blood and strengthen the body and mind.

First of all, it can be used to tonify Blood and Yin in any pattern of

deficiency of Blood and/or Yin. It nourishes Yin firstly because the

Ren Mai controls all the Yin channels and secondly, because Ren-4 is

the meeting point of the Ren Mai with the Liver, Spleen and Kidney

channels. “Dark face” in the above indications is a sign of Kidney-Yin

deficiency.

Besides this, Ren-4 also strengthens the Yang, when used with direct

moxibustion and can be used in this way to rescue the Yang in the acute

stages of Wind-stroke due to collapse of Yang. It can therefore be used

in any pattern from deficiency of Yang, particularly Kidney-Yang.

Ren-4 is probably the main point to affect the Uterus and menstruation,

so that it is used for most menstrual disorders such as amenorrhoea,

scanty periods, irregular periods or heavy periods. Ren-4 also has a

long history of use for infertility. In menstrual problems and

gynaecological problems in general, I usually use Ren-4 in combination

with the opening points of the Ren Mai, i.e. LU-7 Lieque and KI-6

Zhaohai.

It tonifies the Kidneys and Yuan Qi and is a very powerful point to

strengthen the general level of energy and the Kidneys. It is thus an

important point to treat chronic diseases or patients with a poor

constitution. Ren-4 can tonify both Kidney-Yang (with direct

moxibustion) and Kidney-Yin.

Ren-4 point can calm the Shen and settle the Hun by nourishing

Blood and Yin. It can strengthen the Lower Burner in persons who

are very anxious, especially if such anxiety derives from Yin

deficiency. This point tonifies the Qi of the Lower Burner, thus

rooting Qi downwards and subduing the rising of Qi to the head,

which happens in severe anxiety. In this way it has a powerful

calming effect.

Its Kidney-tonic action extends also to that of strengthening the

Kidney's receiving of Qi so that Ren-4 is an important point to

tonify the Kidneys in chronic asthma. In such cases, it is often

combined with KI-13 Qixue.

Some of the indications for Ren-4 pertain to the Chong Mai as this

vessel goes through this point. Chong Mai 's indications for Ren-4

are feeling of cold in the lower abdomen, Running Piglet

Syndrome, abdominal fullness, umbilical pain.

Finally, Ren-4 also affects the Bladder and is used for similar problems

as those indicated by Ren-3. However, although both Ren-3 and Ren-4

affect both Bladder and Uterus, I personally use Ren-3 more for

Bladder problems and Ren-4 more for the Uterus.

To summarize, Ren-4 is probably the most important tonic point of the

body as it tonifies all forms of Qi as follows:

.Qi

.Yang

.Blood

.Yin

.Jing

.Yuan Qi

.Kidney-Yin and Kidney-Yang

.The Ren Mai and Chong Mai

.Wei Qi

.Ying Qi.

REN-5 SHIMEN Stone Door

Location

On the midline of the lower abdomen, 2 cun below the umbilicus, 3

cun superior to the pubic symphysis.

a) Nature

Front Mu point of the Triple Burner.

b) Actions

.Opens the Water passages and promotes the transformation and

excretion of fluids in the Lower Burner

.Regulates Qi in the Lower Burner

.Regulates the Uterus

.Strengthens Yuan Qi.

c) Indications

• Difficult urination, retention of urine, painful urination, dark

urine, oedema, diarrhoea, genital itching, swelling of

scrotum, swelling of vulva, swelling of penis

• Twisting pain in the lower abdomen, Hernial and Genito-

Urinary Disorders (shan), umbilical pain, retraction of

testicles, Running Piglet Syndrome

• Persistent lochial discharge, abdominal masses, heavy

periods, stone-like hardness of lower abdomen

• Exhaustion.

d) Comments

In order to understand the function of this point, one must recall

the role of the Triple Burner in relation to Yuan Qi. The Yuan

Qi arises from between the Kidneys and spreads to the 5 Yin

and 6 Yang organs via the intermediary of the Triple Burner.

Ren-5 is the Front Mu point of the Triple Burner and rouses the

Original Qi to circulate to all the organs and channels. It can

therefore be used to tonify Yuan Qi in persons with Kidney

deficiency and a poor constitution.

Another important function of the Triple Burner (and

specifically the Lower Burner) is to transform and excrete

fluids, and to ensure that the Water passages of the Lower

Burner are open.

Ren-5 stimulates this function of the Triple Burner, and

specifically the Lower Burner: its use is therefore indicated for

oedema of the abdomen, urinary retention, difficult urination,

diarrhoea or vaginal discharge.

REN-6 QIHAI Sea of Qi

Location

On the midline of the lower abdomen, 1.5 cun below the

umbilicus, 3.5 cun superior to the pubic symphysis.

a) Nature

Source point for Membranes (Huang).

b) Actions

.Tonifies Qi and Yang

.Raises sinking Qi

.Tonifies Yuan Qi

.Regulates Qi in the Lower Burner.

c) Indications

. Qi deficiency, Original Qi deficiency, collapse of Yang,

tiredness, cold limbs, loose stools, weak voice

. Prolapse of uterus, profuse menstrual bleeding from Qi

deficiency, chronic and persistent vaginal discharge, frequent

urination, incontinence of urine, a feeling of bearing down

. Hernial and Genito-Urinary Disorders (shan), umbilical

pain, abdominal pain.

d) Comments

Ren-6 is a major point of the body. First of all, it has a powerful

tonifying effect on Qi and Yang, especially if used with direct

moxibustion. It can be used for extreme physical and mental

exhaustion and depression.

It tonifies Kidney-Yang and the Yuan Qi and this point is

especially effective when treated with direct moxa cones and can

therefore be used for such symptoms as chilliness, loose stools,

profuse pale urination, physical weakness, mental depression, and

lack of will power.

Ren-6 also raises sinking Qi and is used in all cases of sinking of

Qi in the lower abdomen causing prolapse of uterus, profuse

menstrual bleeding from Qi deficiency, chronic and persistent

vaginal discharge, frequent urination, incontinence of urine, and a

feeling of bearing down.

Besides tonifying Qi, Ren-6 also moves Qi and eliminates

stagnation in the Lower Burner. It can therefore be used for lower

abdominal pain deriving from stagnation of Qi. Combined with

G.B.-34 Yanglingquan, it moves stagnant Qi in the lower

abdomen and relieves pain and distension in this area.

REN-9 SHUIFEN Water Separation

Location

On the midline of the abdomen, 1 cun above the umbilicus, 7 cun

below the sternocostal angle.

b) Actions

Opens the Water passages and promotes the transformation of

fluids.

c) Indications

.Oedema.

d) Comments

Ren-9 is an important point to promote the transportation,

transformation and excretion of fluids in all parts of the body. It is

used whenever there is a Water pathology in the form of

Dampness, Phlegm or oedema. Ren-9 is especially indicated for

ascites (abdominal oedema). A particular combination for

promoting the transformation and transportation of fluids in the

Middle Burner is Ren-9 with Ren-11 Jianli and ST-22 Guanmen.

Its name is a clear reference to its action of promoting the

separation of clear from turbid fluids.

REN-10 XIAWAN Lower Epigastrium

Location

On the midline of the abdomen, 2 cun above the umbilicus, 6

cun below the sternocostal angle.

a) Nature

Meeting of Ren Mai and Spleen channels.

b) Actions

•Promotes the descending of Stomach-Qi

•Resolves stagnation of food.

c) Indications

•Abdominal and epigastric fullness, abdominal hardness,

epigastric pain, nausea, undigested food in the stools.

d) Comments

Ren-10 is a useful point that promotes the descending of Stomach-Qi. By

promoting the descending of Stomach-Qi it is used for retention of food in

the Stomach with such symptoms as abdominal distension, feeling of

fullness after eating and sour regurgitation.

It also promotes the passage of food from the Stomach to the Intestines

and removes obstructions.

This is one of three points that are in control of the three parts of the

epigastrium. If one divides the epigastric area in three equal parts, Ren-13

Shangwan controls the upper part, Ren-12 Zhongwan the middle part,

and Ren-10 Xiawan the lower part. From a Western anatomical point of

view one can say that Ren-13 controls the fundus (upper part) of the

stomach and oesophagus, Ren-12 the body (middle part) of the stomach,

and Ren-10 the pylorus (lower part) of the stomach and the duodenum.

Each of these three points can be used to affect the relevant part of the

stomach with their related disorders. Thus Ren-10 is effective in

stimulating the descending of Stomach-Qi, i.e. in promoting the

movement of food down the pylorus and duodenum. Ren-12 affects the

stomach digestion itself, and Ren-13 affects the oesophagus and stops

hiccup, nausea and belching by subduing rebellious Stomach-Qi.

Ren-13 Shangwan 上脘

Ren-10 Xiawan 下脘

Ren-12 Zhongwan 中脘

REN-11 JIANLI Building Mile

Location

On the midline of the abdomen, 3 cun above the umbilicus, 5 cun

below the sternocostal angle.

b) Actions

.Promotes the Stomach's rotting and ripening of food

.Promotes the descending of Stomach-Qi.

c) Indications

.Epigastric and abdominal distension, abdominal pain,

vomiting.

d) Comments

Ren-11 is widely used for Stomach problems to promote

digestion and stimulate the descending of Stomach-Qi. It is

therefore used for a feeling of fullness and distension in the

epigastrium, nausea, vomiting and epigastric pain. It is better for

Excess patterns.

REN-12 ZHONGWAN Middle of Epigastrium

Location

On the midline of the abdomen, 4 cun above the umbilicus, 4 cun below

the sternocostal angle.

a) Nature

Front Mu point of the Stomach.

Gathering (Hui) point for the Yang Organs.

Front Mu point of the Middle Burner.

Meeting point of Ren Mai, Small Intestine, Triple Burner and Stomach

channels.

b) Actions

.Tonifies Stomach and Spleen

.Resolves Dampness and Phlegm

.Regulates Stomach-Qi

.Calms the Mind.

c) Indications

.Tiredness, loose stools, poor appetite, weak limbs, desire to lie down

.Abdominal fullness, a sticky taste, a feeling of heaviness, nausea

.All diseases of Stomach and Spleen, epigastric pain, poor digestion,

easily full, sour regurgitation, nausea, vomiting, epigastric distension

.Worry, anxiety, pensiveness.

d) Comments

Ren-12 is a major point for many Stomach problem. Although its

indications clearly show that it can be used to harmonize the

Stomach and promote the descending of Stomach-Qi in Full

conditions, I personally use it primarily to tonify Stomach- and

Spleen-Qi in Deficiency patterns (as opposed to Ren-11 Jianli and

Ren-13 Shangwan, which are better for Excess patterns).

Firstly, it tonifies Stomach- and Spleen-Qi, especially if combined

with ST-36 Zusanli. It has a gentle action and is not a strong

tonifying point. It can be used in any Deficiency pattern of Stomach

and Spleen, with such symptoms and signs as lack of appetite,

tiredness and dull epigastric pain relieved by eating.

It is the best point to use, particularly with moxa, for Empty-Cold

patterns of the Stomach and Spleen. This could be used directly on

the point with moxa cones, or the point can be heated with a moxa

stick, or a “moxa box” can be applied on the area around the point.

Ren-12 can also nourish Stomach- and Spleen-Yin and I use this

point whenever the tongue lacks a coating (which indicates a

deficiency of Stomach-Yin) or when the tongue has a Stomach

crack, even in the absence of any digestive symptoms. When I use

it to nourish Stomach-Yin, I combine Ren-12 with ST-36 Zusanli

and SP-6 Sanyinjiao.

Ren-12 has a general tonifying effect also because it is the

Gathering (Hui) point of all the Yang organs.

Another important use of Ren-12 is to resolve Dampness and

Phlegm. It does so by tonifying the Spleen's function of

transportation and transformation of fluids. It is very widely used in

any pattern involving Dampness or Phlegm in any part of the body.

It is interesting that the traditional indications for this point include

“worry, anxiety and pensiveness”. I personally find Ren-12

effective in calming the Mind in patients who suffer from digestive

problems caused by emotional strain. For this action, I usually

combined Ren-12 with Ren-15 Jiuwei and Du-24 Shenting.

Central Stomach crack Central Stomach crack

and scattered ST cracks

Scattered Stomach cracks

Scattered Stomach

cracks and Spleen-Yin

cracks

Central Stomach crack

and scattered ST cracks

Scattered Stomach cracks

REN-13 SHANGWAN Upper Epigastrium

Location

On the midline of the abdomen, 5 cun above the umbilicus, 3 cun

below the sternocostal angle.

a) Nature

Meeting point of the Ren Mai, Stomach and Small Intestine

channels.

b) Actions

.Subdues rebellious Stomach-Qi.

c) Indications

.Nausea, vomiting, vomiting of blood, difficulty in

swallowing, sour regurgitation, epigastric distension and

fullness.

d) Comments

Ren-13 is the best point to subdue rebellious Stomach-Qi, causing such

symptoms as hiccup, belching, nausea, vomiting and a feeling of fullness

in the upper epigastrium. It is used mostly in Excess patterns of the

Stomach.

It is useful to compare and contrast the actions of Ren-13 and Ren-10

Xiawan. The former, pertaining to the upper part of the Stomach,

“subdues rebellious Stomach-Qi” while the latter, pertaining to the lower

part of the Stomach “promotes the descending of Stomach-Qi”: although

similar, these two actions are not exactly the same.

Ren-13 actively subdues rebellious Stomach-Qi when this causes strong

nausea, vomiting, belching and hiccup. When Stomach-Qi fails to

descend, it will also cause some nausea but this will be slight and

probably it will be confined to nausea without vomiting. When Stomach-

Qi fails to descend, moreover, there will be symptoms in the lower

abdomen as Stomach-Qi is not going down to the Intestines effectively:

Ren-10 is the point to promote the descending of Stomach-Qi in this

context. By contrast, when Stomach-Qi rebels upwards, there will be

symptoms only in the Upper Burner (i.e. hiccup, reflux, belching, nausea

and vomiting): Ren-13 is the point to subdue rebellious Stomach-Qi.

I often use Ren-13 for morning sickness in pregnancy with ST-36 Zusanli

and P-6 Neiguan.

CLINICAL NOTE

Ren-13 Shangwan subdues rebellious Stomach-Qi while

Ren-10 Xiawan promotes the descending of Stomach-Qi.

These two actions are not the same. “Subduing rebellious

Stomach-Qi” means that it is used in Full conditions with

rebellious Stomach-Qi (nausea, vomiting, acid reflux,

belching).

“Promoting the descending of Stomach-Qi” means that it is

used in Empty conditions when Stomach-Qi is not

descending because it is Empty.

Ren-13 Shangwan 上脘

Ren-10 Xiawan 下脘

Rebellious ST-Qi (Full)

ST-Qi not descending (Empty)

REN-15 JIUWEI Dove Tail

Location

On the midline of the abdomen, 7 cun above the umbilicus, 1 cun below

the sternocostal angle.

a) Nature

Luo point of the Ren Mai.

Yuan point of the 5 Yin organs (Chapter 1 of the “Ling Shu”)

Yuan point of Fat Tissue (Gao) (Chapter 1 of the “Ling Shu”).

b) Actions

.Calms the Mind and opens the Mind's orifices

.Opens the chest and promotes the descending of Qi.

c) Indications

.Manic-depression, palpitations, anxiety, insomnia

.Fullness and pain of the chest, wheezing, breathlessness, a feeling of

oppression of the chest, sighing, cough.

d) Comments

Ren-15 is an important and powerful point to calm the Mind.

According to chapter 1 of the “Ling Shu”, it is the source point of

all the Yin organs, which means that it affects the Yuan Qi of all Yin

organs.

It has a powerful calming action in severe anxiety, worry,

emotional upsets, fears or obsessions. Although its indications

show that it can be used to open the Mind's orifices in serious

mental conditions from a Full condition, I personally use this point

in mental-emotional states occurring against a background of

deficiency of Blood or Yin.

Ren-15 opens the chest and promotes the descending of Qi. A

useful aspect of this action is that Ren-15 promotes the descending

of both Lung-Qi (cough, wheezing, breathlessness) and Heart-Qi

(anxiety, sighing, feeling of oppression of the chest).

This point is located at the tip of the xyphoid process which is

commonly known as “dove-tail” in China, hence the name of the

point.

12. HERBAL THERAPY

a) Herbs

Gui Ban Plastrum Testudinis.

b) Formulae

• Bie Jia Carapax Trionycis

• E Jiao Gelatinum Corii Asini

• Zhi Mu Anemarrhena asphodeloides

• Huang Bo Cortex Phellodendri

• Xuan Shen Radix Scrophulariae ningpoensis

• Sheng Di Huang Radix Rehmanniae glutinosae

Ye Tian Shi

Da Bu Yin Wan Great Tonifying Yin Pill.

Zhi Mu

Gui Ban

E Jiao

Bie Jia

Huang Bo Xuan Shen

Sheng Di Huang

CHONG MAI 冲 脉

THE PENETRATING VESSEL

Giovanni Maciocia

Starting point: Ren-1 Huiyin

CHONG MAI POINTS

Coupled point: P-6 Neiguan

Opening point: SP-4 Gongsun

CHONG MAI POINTS

ST-30 Qichong

Ren-1 Huiyin

All Kidney points from KI-11 Henggu to KI-21

Youmen.

Throat, face, head

Uterus (prostate), lumbar spine,

abdomen

Channels influenced: Spleen, Stomach, Liver, Kidneys, Heart, Small

Intestine, Large Intestine.

Big toe, feet, medial aspect of legs

BODY AREAS INFLUENCED

Chest, heart, breasts

The Chong Mai is very complex as it has many different functions at

different levels and affects several organs.

In a way, it could be considered to be the origin of the other

Extraordinary Vessels as it originates in between the Kidneys and

spreads its Qi all over the abdomen and chest and all over the body at

the Wei Qi level.

When this energy arrives at the relevant starting points, it gives rise to the Yin

and Yang Wei Mai, the Yin and Yang Qiao Mai and the Dai Mai.

Du Mai

Chong Mai

Dai Mai Yin/Yang Qiao Mai

Yin Wei Mai

Ren Mai

Yang Wei Mai

冲 衝

街

CHONG (Modern) CHONG (Traditional)

JIE (Streets)

行 XING (to move,

movement)

Phonetic

CHI

Left

foot

print

CHU

Rightfo

ot print

CHONG (1st tone)

1. To charge, dash, rush

2. Thoroughfare, important place

3. To clash, collide

4. With vim and vigour (4th tone)

5. To rinse, flush

6. To infuse

衝 冲

“thoroughfare, important place”.

...“charge, rush, dash”...

Chinese books say that, in the context of the Chong Mai, chong has also the meaning of jie

("streets"), dong (“activity, movement”), xing (“movement”) and tong (“free passage”).

街 Jie 动 Dong 行 Xing 通 Tong Street To move Movement To penetrate

I chose the word “penetrating” as it combines the idea of “rushing”

with that of “streets, channels” that “penetrate” the body.

All these words and the attributes they represent apply to the

Chong Mai (as we shall see, also that of “streets”) and it is

difficult to choose a single English name for it.

The idea of “penetrating” is also related to the penetration of

Membranes (Huang) and channels by the Chong Mai.

The Chong Mai is described as the

“Sea of the 5 Zang and 6 Fu”

“Sea of the 12 channels”

“Sea of Blood”

It is connected to the Kidneys as it originates in

that area and it distributes Jing all over the body.

It is connected to the Stomach as it passes

through the point ST-30 Qichong which is a

point for the Sea of Food.

It is described as the Sea of the 5 Zang and 6 Fu as it is a

fundamental vessel which connects the Pre-Heaven and the Post-

Heaven Qi, due to its connection with Kidneys and Stomach.

ST-30 Qichong 气 冲 (衝)

It is called the Sea of the 12 channels because it

influences all the channels of the abdomen.

It is called the Sea of Blood because it is related to the

Blood in the Uterus and because it controls all the

Deep (Blood) Luo channels.

“The Chong Mai is the Sea of the 12 Channels: its upper

point is BL-11 Dashu and its lower points ST-37 Shangjuxu

and ST-39 Xiajuxu.”

Chapter 33 of the Ling Shu

FIVE BRANCHES OF THE CHONG MAI’S PATHWAY

Head branch

Spinal branch Descending

branch

Internal branch Abdominal branch

CHONG MAI PATHWAY

ST-30

•Branch 2 (Abdominal branch) –This branch

emerges at ST-30, connects with the Kidney

meridian at KI-11 and ascends through the

Kidney channel to KI-21, then disperses in the

chest and breast.

•Branch 3 (Head branch) Ascends along the

throat, chin, curves around the lips and terminates

below the eyes.

•Branch 5 (Descending branch) Emerges at ST-

30, descends along the medial aspect of the legs,

and the medial malleolus. On the foot, it

separates at the heel, one branch going to the arch

of the foot to connect with the Kidney channel

and the other branch going to the big toe to

connect with the Liver channel.

•Branch 1 (Internal branch) Originates inside the

lower abdomen (uterus in women) and emerges at

the Perineum (REN-1).

REN-1

Branch 1

Branch 2

Branch 3

Branch 4

Branch 5

REN-1

•Branch 4 (Spinal branch) Emerges from Ren-1

and ascends inside the Lumbar spine to the level

of BL-23.

CHONG MAI PATHWAY ACCORDING TO CLASSICAL TEXTS

Chapter 39

Su Wen, chapter 60

“The Chong Mai starts at ST-30 Qichong, close to the Kidney channel,

it goes up both sides of the umbilicus to disperse into the chest.”

“The Chong Mai starts at Ren-4 Guanyuan.”

“The Chong Mai starts at ST-30 Qichong and rises parallel to the

Stomach channel, surrounds the umbilicus and then disperses inside

the chest.”

Nan Jing chapter 28

“The Chong Mai is the Sea of the 12 Channels and the Great Luo

channel of the Kidneys. It originates below the kidneys and surfaces at

ST-30 Qichong. It then goes down the inside of the thigh to behind the

knee, down inside the lower leg bone along the Kidney channel to reach

the internal malleolus where it divides. One branch goes down to the

Kidney channel, the other to the dorsum of the foot and then down to

the area between the first and second toe, where it pours in the Luo

channels keeping the lower leg warm.”

Ling Shu, chapter 62

“The Chong Mai is the Sea of the 5 Zang and 6 Fu, it rises up to the neck

and chin oozing into the Yang and irrigating the Jing. Then it goes down

pouring into the Great Luo channel of the Kidneys, exits at ST-30 Qichong.

It goes down the thigh, entering behind the knee, then down along the bone

of the leg on the medial side to reach the internal malleolus where it

separates. One branch runs alongside the Kidney channel oozing into the

three Yin; another branch comes up the dorsum of the foot and then down

to the space between the first and second toe oozing into the Luo channels

and warming the muscles.”

Ling Shu chapter 38

Lei Jing chapter 38

“The Chong Mai starts at Qijie, it connects with the Kidney channel, it

rises up the abdomen either side of the umbilicus, it reaches the chest

where it disperses. “Starts” indicates that the vessel emerges towards

the surface at this point, not that it originates from that point. Qijie is

Qichong [ST-30], a point of the Stomach channel on either side of the

pubic bone. It goes to KI-11 Henggu, KI-12 Dahe, etc. in total [along]

11 points.

“The Chong Mai starts at ST-30 Qichong and joins the Kidney channel

to flow up to the umbilicus and then to the chest where it disperses.”

Jia Yi Jing

Although the texts do not specifically name the point between the first and

second toe, it is generally accepted that this is LIV-3 Taichong because:

“Another branch descends connecting with the Great Luo channel of the

Kidneys, it emerges at ST-30 Qichong, it descends along the inner thigh,

enters the back of the knee, it goes down along the inner aspect of the tibia,

to reach the internal malleolus where it divides.

One branch goes down to connect with the Kidney channel, pouring into

the 3 Yin; another branch goes to the arch of the foot and then to the space

in between the big toe, pouring into the Luo channels and warming the

muscles. When the Luo channels [in the foot] stagnate, the arch [of the

foot] cannot be lifted and it becomes cold.”

Lei Jing

2. Chapter 1 of the “Su Wen” refers to the “Chong Mai” as the “Taichong

Vessel”, i.e. the “LIV-3 Vessel”.

1. The chong in the name for LIV-3 Taichong 太 冲 is the same character as

in Chong Mai

SPINAL BRANCH

Jia Yi Jing

“The Chong and Ren Mai start from the uterus, rise up inside

the spine, they are the Sea of the Channels. [The Chong Mai]

rises up the surface of the abdomen, reaches the throat and

then encircles the mouth.”

(This passage seems to imply that both the Chong and Ren

Mai rise up inside the spine).

THE PATHWAY OF THE CHONG MAI ACCORDING TO LI SHI ZHEN

“The Chong Mai is the Sea of the Channels and the Sea of Blood. It

originates in the lower abdomen and inside the uterus together with

the Ren Mai.

It then emerges at ST-30 Qichong between the Stomach and Kidney

channel and then flows up to KI-11 Henggu bilaterally and 5 fen from

the midline. After which, it flows to:

KI-21 Youmen

KI-20 Tonggu

KI-19 Yindu

KI-18 Shiguan

KI-17 Shangqu

KI-16 Huangshu

KI-15 Zhongzhu

KI-14 Siman

KI-13 Qixue

KI-12 Dahe

KI-11 Heng Gu

Then it disperses in the chest.

This passage clearly implies that the Chong Mai flows through

the points of the Kidney channel only up to KI-21 Youmen.

Whereas some authors believe it flows through all the Kidney

channel points up to KI-27 Shufu

Determines the 7- and 8-year life cycles of women and men

respectively and is closely involved in the transformation of

the Kidney-Jing into Tian Gui, i.e. menstrual blood in women

and sperm in men.

THE INTERNAL BRANCH

SIGNIFICANCE OF THE BRANCHES OF THE CHONG MAI

Functionally very closely related to the Kidneys and the Uterus. Therefore

it is very important in gynaecological problems.

All the points of the Chong Mai on the lower abdomen affect

the Kidneys and the Uterus.

In men, it may also flow through the prostate.

Rebellious Qi of the Chong Mai affects this branch causing a variety of

different symptoms from the lower abdomen to the chest, breasts,

throat and face.

This branch also disperses in the breasts and, in pathology, it causes

many breast pathologies (distension, lumps, lactation problems).

THE ABDOMINAL BRANCH

This branch also penetrates the Membranes (Huang) of the abdomen and

some of the symptoms of rebellious Qi of the Chong Mai are due to

tension and tightness of the Membranes (fullness, distension and pain of

the abdomen).

肓

The abdominal branch of the Chong Mai rises up the abdomen,

epigastrium and chest and affects all channels of these areas. It is the

“streets of Qi” of the abdomen and of the chest

Rebellious Qi of the Chong Mai often causes a feeling of lump in the

throat (which therefore is not always related to Liver-Qi stagnation).

THE HEAD BRANCH

The Chong Mai brings Qi and Blood to the chin area and, due to

menstruation, women have relatively less Blood than Qi in this area

compared to men. The lack of Blood is the reason why women do not

have a beard; men have relatively more Blood in the head branch of the

Chong Mai, which promotes the growth of hair on the face.

Ling Shu chapter 65

UTERUS

PERIODS

Chong Mai has

less Blood in face

Chong Mai has

more Blood in face

ROOM OF JING

The head branch of the Chong Mai is responsible

for the apparently contradictory feeling of heat of

the face in rebellious Qi of this vessel

(contradictory because it is associated with cold

feet).

Facial hair increases after the menopause as then

this branch has more Blood than before. Facial

hair in women also increases in polycystic ovary

syndrome: due to accompanying amenorrhoea or

oligomenorrhoea.

THE SPINAL BRANCH

This branch accounts for menstrual pain that is sometimes felt in the

lower back.

Through the descending branch of the Chong Mai, the Kidneys bring Yin

Qi down to the legs.

THE DESCENDING BRANCH

In chapter 38 of the “Ling Shu ” the Yellow Emperor wonders why the

Yin Leg channels flow from the feet to the abdomen/chest except for the

Kidney channel that descends. The answer clarifies that it is not the

Kidney channel, but the descending branch of the Chong Mai that

descends.

This implies that the Chong Mai has the important function of ensuring

the descending of Yin to the legs: this means that it is the vessel to treat

whenever there is a deficiency of Yin in the legs, as, for example, in

restless leg syndrome.

1. It is an important way in which Kidney-Qi descends to the legs.

CLINICAL SIGNIFICANCE OF THE DESCENDING BRANCH’S

RELATIONSHIP TO THE LEGS

2. It influences all three Yin of the leg and it strengthens the interaction among the

Liver, Spleen and Kidney channels. This is probably also the reason that SP-6

Sanyinjiao is a meeting point of the three Yin channels of the leg. Also pathology

of the Chong Mai may affect the Liver, Spleen and Kidney channels on the leg. In

addition, whenever we use the three Yin channels of the leg (especially in

combination) we are affecting the Chong Mai as well.

3. The descending branch of the Chong Mai brings Qi to the feet - warming them.

Therefore, cold feet could be a pathology of the Chong Mai, i.e. its Qi failing to

descend.

4. The descending branch of the Chong Mai ends at LIV-3 Taichong: therefore this

point acts on the Chong Mai. Therefore, this is an important point to move Blood

in the Uterus.

5. SP-6 Sanyinjiao affects the Uterus and is effective in gynaecological conditions,

probably due to its connection with the Chong Mai.

6. Fungal infections of the big toe may be a symptom of a Chong Mai's pathology.

The Chong Mai is connected to the channels along which it

flows on the inner aspect of the leg, down to the big toe.

• Spleen

• Liver

• Kidney

The “Lei Jing” has an interesting summary of the energetic sphere of action

of the Chong Mai and explains more in depth the meaning of this vessel's

being the “Sea of the 12 Channels”:

“The Chong Mai is the Sea of the 12 Channels, it goes upwards to connect

with Bl-11 Dashu and downwards to connect with ST-37 Shangjuxu and ST-

39 Xiajuxu. The Chong Mai goes down to ST-30 Qichong and up to

connect with the Kidney channel. It goes up the eyes and head and down to

the feet; it goes to the back [in the lumbar spine] and to the front in the

abdomen. It goes into the Interior in the rivers and valleys [the big and

small muscles of the abdomen] and into Exterior in the skin and muscles. It

therefore connects with both Yin and Yang and both Interior and

Exterior...100 diseases originate from the Chong Mai because it is the

most 'penetrating' [of the channels]. It controls the Qi and Blood of the 12

Channels which nourish the whole body and for this reason it is called the

Sea of the 5 Zang and 6 Fu.”1

1. Classic of Categories, Lei Jing, p. 281.

CLINICAL SIGNIFICANCE OF THE VARIOUS NAMES OF THE CHONG MAI

The Chong Mai is variously called the:

“Sea of Blood”

“Sea of the 12 Channels”

“Sea of the 5 Yin and 6 Yang Organs”

SEA OF BLOOD

Although the Chong Mai is the Sea of Blood it is referred to as the “Sea of

the 12 Channels”: “The Chong Mai is the Sea of the 12 Channels; its

upper Transporting [Shu] point is BL-11 Dashu and its lower Transporting

points ST-37 Shangjuxu and ST-39 Xiajuxu.”

Therefore, the points BL-11 Dashu and the pair ST-37 Shangjuxu and ST-

39 Xiajuxu are the upper and lower points of the Sea of Blood

respectively.

Ling Shu chapter 33

“When the Seas function harmoniously there is life; when they function

against the normal flow there is disease...When the Sea of Blood is in

excess, the person has the feeling of the body getting bigger and the

person is unable to pin-point the trouble; when the Sea of Blood is

deficient, the person has the feeling of the body getting smaller and is

unable to pin-point the trouble.”

PATHOLOGICAL SYMPTOMS OF THE SEA OF BLOOD

It is obvious that the Sea in this passage refers to the Sea of Blood because:

Ling Shu chapter 33

1. It is mentioned in the same breath as the Sea of Qi, Sea of Food and

Sea of Marrow

2. The passage refers to the “transporting” (shu) points of this Sea as BL-

11, ST-37 and ST-39; these are the points of the Sea of Blood.

The above symptoms of Fullness and Emptiness of the Sea of Blood are rare

and not clinically important. It is unclear how the above points are connected

to the Chong Mai or why they are points of the Sea of Blood.

The most important aspect of the Chong Mai as the Sea of Blood is in

gynaecology.

The Chong Mai has a deep influence on the gynaecological system because:

• it originates from between the Kidneys

• it is responsible for the 7-year cycles of women

• it is responsible for the transformation of Kidney-Jing into menstrual

blood

• it flows through the Uterus

To invigorate Blood of the Chong Mai in gynaecology, one needs to use the

opening and coupled points (SP-4 Gongsun and P-6 Neiguan) together with

KI-14 Siman and LIV-3 Taichong.

The Chong Mai affects all of these channels through its opening and

coupled points (SP-4 and P-6). As these channels are involved in Blood

stasis, the Chong Mai can be used to treat Blood stasis anywhere in the

body.

The Blood of the whole body relies on the Chong Mai for its movement

and circulation. The Chong Mai controls all the Blood Luo channels,

which are the deep level of the Luo channels, an energetic level that is

connected with Blood and blood vessels.

Yang Shang Shan says: “Under the umbilicus is the Motive Force [Dong

Qi] in between the two kidneys which governs human life and is the root of

the 12 channels: this is the Sea of Blood of the Chong Mai, the Sea of the 5

Zang and 6 Fu and of the 12 channels. It oozes into the Yang, irrigates the

Jing...it is the Motive Force below the umbilicus and in the uterus. It

moves upwards and downwards, it is the Chong Mai.”

The Chong Mai influences the movement of Qi and Blood in the whole body.

The Chong Mai’s control of all the Blood-Luo channels explains the

connection between disharmony of Blood in the Uterus and the development

of muscular pains, something which often occurs after childbirth. It also

explains why women often suffer external invasions during menstruation.

The depletion of Blood in the Chong Mai induces an emptiness of the

Blood-Luo channels: this affects the superficial Luo channels and

therefore the space between skin and muscles becomes empty and prone

to invasion of external pathogenic factors.

As we have seen above, the Chong Mai controls all Luo channels and

it goes to the Exterior of the body.

Cou Li space

4. It controls all the Luo channels including Blood Luo.

1. It affects several channels all over the body except the arms

3. It controls all the secondary channels over the abdomen and chest. (See

chapter 65 of the Ling Shu 冲 脉 其 浮 而 外 = the Chong Mai goes to the

surface and the Exterior)

The Chong Mai is also the Sea of the 12 channels because:

THE SEA OF THE 12 CHANNELS

2. It affects all the channels of the abdomen and chest (“Streets of Qi of the

abdomen” and “Streets of Qi of the Chest”)

THE CONCEPT OF “STREETS”, “AVENUES” OR CROSSROADS” (JIE)

Ling Shu chapter 52

“In the chest Qi has streets; in the abdomen Qi has streets; in the head Qi

has streets; in the lower legs Qi has streets. Therefore if [there is a problem

with] Qi in the head, stop it at the brain; if [there is a problem with] Qi in

the chest, stop it at the front of the chest and at the Back-Shu points; if

[there is a problem with] Qi in the abdomen, stop it at the Back-Shu points

and at the Chong Mai on the right and left of the umbilicus which is the

Moving Qi [or Dong Qi]; if [there is a problem with] Qi in the lower legs,

stop it at ST-30 Qichong [here called Qijie] and at BL-57 Chengshan.”

The Chong Mai controls all the channels (“streets”) of the abdomen and the

alternative name of ST-30, “Avenues of Qi” (Qijie), is significant. The Qi

of the Chong Mai emerges from the deep abdomen at this point, which has

a powerful dynamic effect on the circulation of Qi in the channels of the

abdomen. The Chong Mai is also sometimes called “Sea of Avenues of the

Abdomen”.

PATHWAYS OF QI (QI JIE) 气 街

Su Wen chapter 58

“The back and chest are connected diagonally [and so are] Yin and

Yang, left and right. This way, their diseases cause pain and roughness

in the front and back.”

Commentary says: “The Luo of the Du Mai rises on both sides of the

nape and disperses on the head. It descends along the scapulae. A

branch of the Du Mai leaves from the sacrum and encloses chest and

flanks. Its Luo props the heart and penetrates the diaphragm, rises to

scapulae and intersects with Ren Mai at Ren-22. It descends again from

the shoulder diagonally and intersects with the Du Mai below the 10th

vertebra. Hence the chest and back pull on each other and have pain.”

PATHWAYS OF QI (QI JIE)

Under influence of Chong Mai

PATHWAYS OF QI (QI JIE)

Under influence of Chong Mai

The Chong Mai is the “Sea of the 5 Yin and 6

Yang Organs” because it is the extraordinary

vessel at the centre of the energetic vortex created

by them. It is the “father” of the other

extraordinary vessels.

SEA OF THE 5 ZANG and 6 FU

Due to its complex pathway, the Chong Mai influences many organs

directly. As we have seen, it is directly related to the three Yin of

the leg, Kidneys, Liver, and Spleen. It is closely connected to the

Stomach (emerging at ST-30) and the Heart.

Therefore, it is related to the Kidney (Pre-Heaven Qi), Stomach and

Spleen (Post-Heaven Qi), and the Heart (the Emperor), which are

the Three Treasures of Jing, Qi and Mind. It is also closely

connected to the Liver channel in the legs and in the abdomen.

The Chong Mai is the Sea of Blood and its pathology is at the root of many

gynaecological problems. The three Blood pathologies that affect the Chong

Mai are:

BLOOD STASIS IN GYNAECOLOGY

1) Blood deficiency

2) Blood Heat

3) Blood stasis

When there is Blood Heat, the periods may be very heavy.

When there is Blood deficiency, the woman may suffer from

amenorrhoea or scanty periods.

When there is Blood stasis the periods will be painful and the menstrual

blood will be dark with clots.

Blood stasis in the Uterus is the pathology of the Chong Mai, therefore,

when this occurs, the Chong Mai is used to invigorate Blood.

The points to use are the opening and coupled points (SP-4 and P-6) together

with KI-14 Siman and LIV-3 Taichong, SP-10 Xuehai.

Secondary Manifestations:

• Periods that start and stop

• Brownish discharge before or after menses

• Pulse – “Firm” (“Lao” = prison; confined)

CLINICAL MANIFESTATIONS OF BLOOD STASIS IN GYNAECOLOGY

Primary Manifestations:

• Dysmenorrhea

• Large, dark clots (this sign alone indicates Blood stasis)

• Purple tongue (use the tongue to gauge the degree of Blood stasis)

Superficial

Middle

Deep

Firm is similar to Wiry but is not felt

at the superficial level

BLOOD STASIS IN THE UTERUS

Blood stasis in the Uterus is very common and is the cause of many

gynaecological complaints such as painful periods, infertility, myomas,

menorrhagia.

Clinical manifestations

Painful periods with dark blood and large-dark clots, pre-menstrual

abdominal pain, hesitant start to the periods, period starts and stops,

infertility, myoma, amenorrhoea, period starting or ending with a brownish

discharge. Tongue Purple on the sides. Pulse Firm in Middle and Deep

levels.

Acupuncture

Chong Mai (SP-4 Gongsun on the right, P-6 Neiguan on the left), KI-14

Siman, LIV-3 Taichong, Ren-6 Qihai, ST-28 Shuidao, SP-10 Xuehai, SP-8

Diji, BL-17 Geshu, Ren-4 Guanyuan, SP-6 Sanyinjiao.

Prescription

a) Wen Jing Tang if due to Cold (strictly speaking it is for Full Cold but it can be

used for Empty Cold)

b) Tao Hong Si Wu Tang

c) Ge Xia Zhu Yu Tang

d) Shao Fu Zhu Yu Tang (from Cold)

e) Gui Zhi Fu Ling Wan for masses

f) Sheng Hua Tang for retention of lochiae

g) Shi Xiao San

Women’s Treasures remedy

Stir Field of Elixir , Harmonizing the Moon and Invigorate Blood and Stem

the Flow

Ge Xia Zhu Yu Tang Gui Zhi Fu Ling Wan Tao Hong Si Wu Tang Wen Jing Tang

Acupuncture Treatment for Blood Stasis

Invigorate Blood during the menses (Phase 1) and Phase 4.

Points:

Chong Mai: SP-4 Gongsun and P-6 Neiguan, KI-14 Siman, ST-29

Guilai and LIV-3 Taichong

SP-10 Xuehai and BL-17 Geshu

Heavy menses: do not use too many abdominal points

Normal/ scanty menses: more abdominal points

LIVER-3 TAICHONG 太 冲

Su Wen, chapter 1

“When a girl is 14, Tian Gui arrives, the Ren Mai is open, the

Taichong Vessel is flourishing, menstruation begins and she can

conceive.”

In this passage, therefore the Chong Mai is called the “Liver-3

Vessel”: this point is closely identified with the Chong Mai due

to its descending branch reaching this point.

Whenever we use this point, therefore, we activate the Chong

Mai and invigorate Blood (although we may also subdue

rebellious Qi).

The gynaecological effect of this point is due to its being a

Chong Mai point.

CHONG MAI REBELLIOUS QI

COLD

HOT

Qi Rebellious

Qi Deficient in

leg branch

Kidney channel

REN-1

LEGS LEGS

FACE

UTERUS

BLOOD

YIN

Rebellious Qi of the Chong Mai

causes various symptoms at different

levels of the abdomen and chest. It

causes primarily fullness, distension

or pain in these areas.

By plotting the pathway of the Chong

Mai, we can list the possible

symptoms of rebellious Qi of the

Chong Mai starting from the bottom:

Cold feet

Fullness/distension/pain of the epigastrium

Feeling of tightness below the xyphoid process

Hypogastric fullness/distension/pain

Fullness/distension/pain of the umbilical area

Fullness/distension/pain of the lower abdomen

Painful periods, irregular periods

Slight breathlessness

Sighing

Palpitations

Feeling of tightness of the chest

Feeling of distension of the breasts in women

Headache

Feeling of heat of the face

Feeling of lump in the throat

Anxiety, mental restlessness, “internal urgency” (Li Ji).

In order to diagnose Rebellious Qi of the Chong Mai, you need at least 3-4 symptoms at different levels

REBELLIOUS QI AND "INTERNAL URGENCY" (LI JI).

“The pathology of the Chong Mai is rebellious Qi with internal urgency [li

ji].”

Nan Jing, chapter 29

Rebellious Qi and "internal urgency" are the most common pathologies of the

Chong Mai

Internal urgency (Li Ji)

• indicates a feeling of vague anxiety and restlessness.

• may also be interpreted as an uncomfortable, tight sensation from

the lower abdomen upwards towards the heart.

• modern Chinese books say it may also indicate pain, constipation,

retention of urine, hernia, anxiety, dizziness and nausea, especially with

an emotional background.

“When Qi rebels upwards, there is internal urgency [li ji] and a feeling of

heat: this is rebellious Qi of the Chong Mai.”

Li Shi Zhen

What makes the Qi of the Chong Mai rebel upwards?

In my experience, this may happen for two reasons:

1) the Qi of the Chong Mai can rebel upwards by itself due to emotional stress

that makes Qi rise or stagnate. This condition is Full and I call it “primary”

rebellious Qi.

2) Qi may also rebel due to a Deficiency in this vessel (of Blood and/or

deficiency of Kidney Yin or Yang) in the lower abdomen. In such cases, Qi of the

lower Dan Tian is weak and the Qi of the Chong Mai “escapes” upwards. This is

a mixed Full/Empty condition and I call this “secondary” rebellious Qi of the

Chong Mai. This is more common in women.

Lei Jing

“The Qi of the Chong Mai rises up to the chest, Qi is not regulated and therefore

it rebels in the diaphragm, Blood is deficient and therefore there is internal

urgency in the abdomen and chest.”

ACUPUNCTURE TREATMENT FOR REBELLIOUS QI

Left Side Right Side

1. SP-4

3. LI-4 2. P-6

5. KI-21

6. KI-14

4. LIV-3

“Primary” rebellious

Qi (i.e. Full type) in a

woman

ACUPUNCTURE TREATMENT FOR REBELLIOUS QI

Left Side Right Side

“Secondary”

rebellious Qi

(i.e. Full/Empty

type) in a

woman

1. SP-4

3. LI-4 2. P-6

5. KI-21

6. KI-13 and

Ren-4

4. LIV-3

SPECIAL FORMULA FOR REBELLIOUS QI OF CHONG MAI

SP-4 Gongsun, P-6 Neiguan, ST-30 Qichong, KI-14 Siman, KI-13 Qixue,

LIV-3 Taichong, BL-15 Xinshu, BL-18 Ganshu, SP-6 Sanyinjiao.

Explanation

This formula is used for Liver-Qi stagnating in the lower abdomen and Qi of

the Chong Mai rebelling upwards to disturb the Heart. This condition arises

from shock, worry, pensiveness or guilt which cause stagnation of Qi.

The Liver channel courses through the lower abdomen, the stomach,

diaphragm, lungs and throat; the Kidney channel goes through the liver,

diaphragm, lungs and throat. Thus they both go up to the throat where they

may cause a feeling of constriction of the throat.

They both also go to the chest where, with stagnation of Qi, they may cause a

feeling of oppression and tightness of the chest. In the chest, they affect the

Heart and Lungs and therefore Shen and Po, giving rise to anxiety, palpitations

and unhappiness.

- KI-14 also subdues rebellious Qi in the Chong Mai when this affects the

lower abdomen. The name of this point means "four fullnesses" which may

refer to a feeling of fullness of the lower abdomen radiating in all four

directions: this feeling of fullness derives from stagnation of Qi in the

Penetrating Vessel. Another meaning of its name is that the point treats four

fullnesses deriving from stagnation of Qi, Blood, food, and Dampness.

- KI-13 is another point along the Chong Mai and it also regulates its Qi by

strengthening its root in the lower abdomen.

- LIV-3 subdues rebellious Qi in the Liver channel and settles the Hun.

- P-6 also subdues rebellious Qi in the Liver channel, relaxes the chest,

calms the Mind, settles the Hun.

- BL-15 and BL-18 regulate Qi of the Heart and Liver channel, move Qi,

calm the Mind, and settle the Hun.

- SP-6 helps to subdue rebellious Qi by strengthening the root, i.e. Liver and

Kidneys.

Ling Shu, chapter 65

“The Chong and Ren Mai originate from the uterus, go up through the spine

and form the Sea of channels... from the abdomen, they go up to the throat.”

Su Wen, chapter 60

“The Chong Mai rises through ST-30 Qichong, follows the Kidney channel to

the umbilicus and chest where it scatters.”

Thus, rebellious Qi in the Chong Mai affects the Heart causing anxiety,

palpitations and mental confusion.

ST-30 is an important point of the Chong Mai which emerges at this point

coming from the perineum. The point name means “rushing Qi” or

“penetrating Qi” and the “chong” in its name refers to the Chong Mai.

ST-30 is therefore used to subdue rebellious Qi in the Chong Mai affecting

not only the lower abdomen, but the whole length of this vessel.

HEART

KIDNEYS

Heart Xu cannot

descend to Kidneys

Yuan Qi Xu cannot

root Qi and receive

Heart-Qi

Fullness above

Deficiency below

YANG

YIN

Yang and Yin cannot communicate

The Membranes represent a whole range of connective tissue

including superficial and deep fascia, peritoneum, mesentery,

omentum, stroma, etc. They cover the whole body with a layer

immediately below the skin and an inner layer wrapping and

anchoring the organs, muscles and bones.

THE CHONG MAI AND THE MEMBRANES (HUANG)

In particular, the Membranes have three functions:

1) they anchor the organs

2) they connect the organs among themselves

3) they wrap the organs

The Chong Mai influences the Membranes in the abdomen and chest.

Rebellious Qi is related to the Membranes, as Qi stagnates in the

Membranes and rebels upwards causing the abdominal and chest symptoms.

肓

POINTS WITH “HUANG” IN THEIR NAMES

- KI-16 Huangshu (Shu point of the Membranes)

- BL-43 Gaohuangshu (Back-Shu point of Gaohuang)

- BL-51 Huangmen (Door of Membranes)

- BL-53-Baohuang (Bladder Membranes)

- Huangmu, extra point (Front-Mu point of Membranes)

The “Great Dictionary of Acupuncture” explains the relationships among

these four points. It says that at the points BL-43 Gaohuangshu, BL-51

Huangmen and BL-53 Baohuang, Kidney-Qi infuses in the back.

In particular, KI-16 Huangshu is in communication with BL-51 Huangmen:

Kidney-Qi infuses into the front and the back of the lower part of the body

through these two points

Cheng Bao Shu 1988 Great Dictionary of Acupuncture (Zhen Jiu Da Ci Dian), Beijing Science Publishing House,

Beijing, p. 95.

According to the “Explanation of the Acupuncture Points”, KI-

16 Huangshu should be seen in connection with BL-17 Geshu.

This point, the Back-Shu point of the diaphragm, influences

the Gaohuang region which is above the diaphragm. BL-17 is

situated either side of the Du Mai, which governs all Yang and

KI-16 is either side of the Ren Mai which governs all Yin.

It is because of the connection between KI-16 and the

diaphragm that it can affect both Heart and Lungs. I use KI-16

to calm the Heart and relieve anxiety deriving from rebellious

Qi of the Chong Mai.

Yue Han Zhen 1990 An Explanation of the Acupuncture Points (Jing Xue Jie), People's Health

Publishing House, Beijing. Originally published in 1654, p. 266.

KI-16 is called “Huangshu” which means “Shu point for Huang”. “Shu”

[俞] is a character that refers usually to points on the back of the body,

such as in the Back-Shu points. The fact that KI-16 is called a Shu point

would seem to confirm the idea that it relates to BL-17 on the back.

. KI-16

. .

.

BL-17

Du Mai, Governor of Yang Ren Mai, Governor of Yin

HUANGMU 肓 募

Front-Mu point of Huang Membranes

1/2 . Huangmu

1) the Chong Mai influences the female breast because it

“disperses” in the chest on its way up to the throat and face.

3) the Chong Mai affects the female breast through the Membranes

(Huang). The Chong and Ren Mai control the Membranes in the

abdomen and chest. The connective tissue within the female breast is

part of the Membranes. Qi stagnation in the Chong Mai always affects

the Membranes and therefore the breasts.

2) the Chong Mai controls all the Luo channels and the female breast

is richly irrigated by Luo channels. Qi stagnation in the Chong Mai

causes breast distension and/or pain and, in the long run, breast

lumps.

THE CHONG MAI AND THE FEMALE BREAST

Because the Chong Mai arises from the Uterus, is

the Sea of Blood and controls the Blood Luo

channels; the Chong Mai is responsible for the

production of breast milk.

Breast milk is a direct transformation of menstrual

blood into milk; menstrual Blood turns into milk and

flows up to the breasts via the Chong Mai.

If the Qi of the Chong Mai stagnates after

childbirth, the breast milk may not come out: this

is a Full condition of agalactia, i.e. the milk is

there but it is difficult to express because of the Qi

stagnation.

On the other hand, if the Blood of the Chong Mai

is deficient, the breast milk may be lacking

because there is not enough Blood to be

transformed into milk: this is an Empty cause of

agalactia.

Blood-invigorating herbs that affect the breasts and the Luo channels

Some Blood-invigorating herbs are also said to “penetrate the Luo”:

they move Qi and Blood and remove obstructions from the Luo

channels.

Used for channel problems and, in gynaecology, for breast problems.

These herbs are: Si Gua Luo Fasciculus vascularis Luffae, Chuan

Shan Jia Squama Manitis pentadactylae and Lu Lu Tong Fructus

Liquidambaris taiwanianae.

A number of herbs have a particular action in removing obstructions from

the Luo Mai of the breast, an expression which attempts to translate the

concise but descriptive Chinese terms tong ru luo [通 乳 络], literally

“penetrating the breasts Luo [channels]”. All these herbs will have an

action in moving Qi and Blood in the Chong Mai because of the relation

between this channel and the Luo Mai and blood vessels.

Chuan Shan Jia Squama Manitis pentadactylae

Lu Lu Tong Fructus Liquidambaris taiwanianae

The main herbs that have this function are:

Ju Hong Medulla Citri reticulatae

Mu Tong Caulis Mutong

Lou Lu Radix Rhapontici seu Echinops

Tong Cao Medulla Tetrapanacis papyriferi

Si Gua Luo Fasciculus vascularis Luffae

The Chong Mai is related to the Heart in two ways:

THE CHONG MAI AND THE HEART

The Chong Mai has a deep influence on the Heart as it flows around the

heart and it disperses in the chest.

1) it disperses in the chest

2) it is the Sea of Blood and the Heart governs Blood.

Therefore the Chong Mai can be used for palpitations and anxiety during

the menopause, symptoms which are themselves caused by the decline of

the Blood of the Chong Mai with consequent rebellious Qi escaping

upwards along the vessel. In the ancient texts, one of the indications of the

Chong Mai are the “nine kinds of heart pain”. The Chong Mai influences

the heart rhythm and can be used for arrhythmia.

Points for HE- palpitations; SP-4 and P-6, LI-4, ST-40, KI-21, KI-16,

Ren-4, KI-13.

HEART

UTERUS

KIDNEYS

Bao Mai (through Chong Mai)

Bao Luo

Discharge of eggs and

menstrual blood

Ebb and flow of Yin and Yang

in menstrual cycle

The Heart is connected to the Uterus via the Uterus Vessel (Bao Mai).

There is a debate as to whether this “Uterus Vessel” (Bao Mai) is part

of the Chong Mai or whether it is a separate channel: I think the

former.

Heart-Qi and Heart-Blood descend towards the Uterus promoting the

discharge of menstrual blood during the bleeding phase and the

discharge of the eggs during ovulation which are under the control of

the Chong Mai.

In the context of the Five Elements, Fire and Water flow towards each

other to establish a connection of mutual assistance. The connection

between the Heart and Kidneys is a manifestation of the basic connection

between Fire and Water

Therefore the Heart-Qi needs to descend towards the Kidneys and

Kidney-Qi needs to ascend towards the Heart.

THE CHONG MAI AND THE HEART-KIDNEYS CONNECTION

The Chong Mai plays an important role in facilitating the important

connection between the Heart and Kidneys, which in turn plays an

important role in many physiological processes.

An ancient doctor attempted to explain the apparent contradiction (of

Fire descending and Water ascending) thus: “The harmony of Heart and

Kidneys depends on the ascending of the Kidney-Qi and descending of

the Heart-Qi. The Kidneys pertain to Water, how can it ascend? Because

there is genuine Yang in Water [i.e. HE-Qi]. The Heart pertains to Fire,

how can it descend? Because there is genuine Yin in Fire [i.e. KI-Qi].”

1) In gynaecology, coordination of Heart and Kidneys is needed to bring about a

normal menstrual cycle, which is a result of the waxing and waning of Kidney-

Yin and Yang. The Heart promotes the change from Yang to Yin at the onset of

bleeding and from Yin to Yang with ovulation. Secondly, the descending of Heart-

Qi to the Kidneys promotes the discharge of menstrual blood with the onset of the

period and that of eggs at ovulation.

The communication between Heart and Kidneys can be observed in the following

physiological processes:

2) The communication between Heart and Kidneys reflects that between the Mind

(Shen) and the Will-power (Zhi): the Mind directs the Will-power and gives it

goals and Will-power gives the Mind the drive and determination to pursue its

goals.

3) In sexual physiology, Heart-Qi also descends towards the Kidneys and the

communication plays a role in erection in men and arousal and orgasm in both

men and women. Thus, in men, erection depends not only on Kidney-Yang but

also on Heart-Qi and Heart-Blood descending towards the Kidneys and the

penis (in the same way as they promote menstruation when they descend

towards the Uterus).

The Chong Mai originates between the Kidneys, and brings Kidney-Qi down to

the legs through its descending branch.

The Chong Mai disperses in the chest and flows to the heart; in addition it is the

Sea of Blood and the Heart governs Blood.

Besides these connections, the Chong Mai is connected to both Heart and Kidneys

through the Uterus Channel (Bao Luo) and the Uterus Vessel (Bao Mai): these are

two vessels that connect the Uterus to Heart above and Kidneys below.

The points which can be used to promote the Chong Mai’s function of connecting

Heart and Kidneys are:

• KI-16 Huangshu

• BL-17 Geshu.

The best combination to stimulate the Chong Mai’s function of promoting the

communication between Heart and Kidneys, I would use its opening and coupled

points (SP-4 and P-6) together with KI-16 Huangshu.

The Chong Mai emerges from the point ST-30 Qichong which is the

upper point of the Sea of Food. The Chong Mai is closely connected to

the Stomach via this point. The Kidneys are the Gate of the Stomach,

hence the Chong Mai, which originates from the Kidneys, treats both

Kidneys (Pre-Natal Qi) and the Stomach (Post-Natal Qi).

THE CHONG MAI AND THE STOMACH

Therefore the Chong Mai can be used for any Stomach disorder

especially those of a Full nature. The opening and coupled points of

the Chong Mai (SP-4 and P-6) and KI-21 Youmen and ST-19 Burong

should be used.

The relationship of the Chong Mai with both the Uterus and the Stomach

explains morning sickness in pregnancy, which is due to rebellious Qi in the

Chong Mai deriving from the profound changes taking place in the Uterus in the

first three months of pregnancy. In women who suffer very severe morning

sickness and vomiting also for longer than 3 months, there is usually a pre-

existing condition of rebellious Qi in the Chong Mai.

Due to the relationship between the Stomach and the Chong Mai, the herb Ban

Xia Rhizoma Pinelliae (which enters the Stomach) is sometimes used to regulate

the Chong Mai: for example, this is the rationale for the inclusion of Ban Xia

Rhizoma Pinelliae in the formula Wen Jing Tang Warming the Menses

Decoction (for Cold in the Uterus).

The Chong Mai affects the Stomach channel's connection with the Heart. The

Great Luo of the Stomach is called Xu Li and the beating of the heart in the left

ventricle represents, from the Chinese point of view, the beating of Xu Li.

Therefore the Stomach channel can be used to treat heart problems, especially

those of arrhythmia. However, the Stomach also influences the Heart via the

Chong Mai.

Some doctors say that, due to the Chong Mai's toe branch, a fungal infection of

the big toe can affect the Heart (due to the connection between this vessel and

the Heart).

THE CHONG MAI AND QI CIRCULATION TO THE FEET

As the Chong Mai's descending branch goes to the dorsum of the foot and big

toe, and as this vessel influences all Luo channels, problems of circulation to the

feet with coldness, numbness, tingling, purple colour, etc. may be related to this

vessel. In these cases treat SP-4 Gongsun and P-6 Neiguan, together with some

abdominal points such as KI-11 Henggu or KI-13 Qixue and SP-6 Sanyinjiao

and KI-4 Dazhong.

THE CHONG MAI AND THE “ANCESTRAL MUSCLE” (ZONG JIN 宗 筋)

Zong Jin translates literally as “Ancestral Muscle”. “Ancestral muscle”

may either refer to the rectus abdominis muscles or the penis. Both views

are supported in ancient texts.

Su Wen Chapter 44

“The Chong Mai... ...connects with the Yang Ming [Stomach channel] in

the Ancestral Muscle [Zong Jin]. Thus, Yin and Yang meet in the

Ancestral Muscle and connect with the avenues of the abdomen which

are under the control of the Stomach.

In this passage “Yin and Yang” refers to the Chong Mai and the Stomach

channel respectively. The Chong Mai and the Stomach channel more or less

enclose the rectus abdominis muscles between them.

The points KI-11 Henggu and ST-30 Qichong are right over the insertion of

the rectus abdominis, another reason why the Kidney and Stomach channels

control the Ancestral Muscle.

Su Wen, chapter 44

"The Yang Ming is the Sea of the 5 Yin and 6 Yang organs, it irrigates the

Ancestral Muscle which runs to the pubic bone and up the spine in the

back."

This statement is the only one which describes the Ancestral Muscle as

running not only up the abdomen from the pubic bone to the xyphoid

process, but also up the back along the spine. This passage, therefore,

includes the spinal muscles in its definition of Ancestral muscles.

If the Chong Mai is not flourishing the ancestral muscles will be slack.

This may cause prolapse of the uterus and various types of atrophy of

the legs.

Looking at the anatomy of the rectus abdominis muscle we see that its

insertion at the pubis bone is just above the root of the penis.

Transversalis Fascia Rectus Abdominis

Linea Alba

Thus, it is easy to see how the “Ancestral Muscle” (Zong Jin) can

well be both the rectus abdominis and the penis.

rectus abdominis insertion

All ancient Chinese texts state that the Du, Ren and Chong Mai either

start from the Uterus or flow through the Uterus: none of these books

say where these vessels flow in men. In my opinion, it can be

postulated that the Chong Mai prostate is the male organ

corresponding to the Uterus: its anatomical location and its functions

support this hypothesis.

THE CHONG MAI AND THE MALE GENITAL SYSTEM

In practice, I often use the Chong Mai to treat problems of the penis of

prostate in men.

Prostate

Scrotum

Chong

The Chong Mai influences erection in seven ways:

1) It is responsible for the filling of blood of the corpus

cavernosum

2) It is connected to the Post-Natal Qi (through ST-30 Qichong) and therefore

provides the necessary Qi for erection

3) It is connected to the Pre-Natal Qi (at Ren-1 Huiyin, KI-13 Qixue and Ren-4

Guanyuan) and therefore provides the Jing for erection

4) It controls the Membranes (Huang) and most of the tissues in the penis are part

of the Membranes

5) The Chong Mai controls the Ancestral Muscles (Zong Jin)

6) It controls the Blood-Luo channels which allow the penis to fill with blood

7) It plays an important role in allowing the communication between Heart and

Kidneys and therefore the descending of Heart-Blood to the penis.

The anatomy of the penis is such that it is richly endowed with Luo channels

because it is a structure that is outside the body and therefore “superficial”.

i) THE PENIS

Ancient doctors were aware of the hormonal connection between the testis and beard

growth and they related this to the Chong and Ren Mai.

ABC of Acupuncture (Jia Yi Jing)

“If there is an injury to the sex organs in men, sexual energy is depleted and the man

cannot have an erection but the beard does not fall off. By contrast, in eunuchs, the

beard falls off, why? [That is because] In eunuchs the Ancestral Muscle [penis] is cut

off: this injures the Chong Mai, Blood is depleted, there is accumulation under the

skin, the mouth and lips do not receive nourishment and therefore the beard does not

grow. In those who are made into eunuchs from birth, the Ren and Chong Mai do not

flourish, the Ancestral Muscle [penis] does not develop, there is Qi and no Blood, the

mouth and lips do not receive nourishment and therefore the beard does not grow.”

Acupuncture Treatment for Erectile Dysfunction

Syndrome Left Side Right Side Bilateral

Full-Empty type SP-4 Gongsun P-6 Neiguan KI-12 Dahe, KI-13 Qixue

KI-11 Henggu, Ren-4 Guanyuan

Ren-6 Qihai, BL-15 Xinshu

BL-23 Shenshu, Ren-15 Jiuwei

ii) THE PROSTATE

The three vessels that arise in the lower abdomen, the Du, Ren and Chong

Mai in men all flow through the prostate on their way down to Ren-1

Huiyin. In my opinion, when considering the physiology and pathology of

the prostate gland in Chinese medicine, the seminal vesicles should be

assimilated with the prostate.

The prostate is related to the Kidney-Jing, as it produces 90% of the

seminal fluid. In men the Du and Ren Mai influence the prostate and the

production of seminal fluid. Sperm is a form of Jing and, as such, it is part

of the Yin Jing (and therefore the Ren Mai); however, the production of

sperm needs the Heat of Kidney-Yang (and therefore the Du Mai).

The two points Ren-4 Guanyuan and Du-4 Mingmen represent the Yin and

Yang aspect of the Jing respectively: in men, they are both needed for the

production of seminal fluid by the prostate.

Prostatic hypertrophy is usually due to Phlegm, Blood stasis with

Dampness. Blood stasis in the prostate is always a pathology of the Chong

Mai; Phlegm and Dampness occur due to a stagnation in the Luo channels

of the prostate. The Chong Mai controls all Luo channels.

Prostatic hypertrophy should be treated by tonifying the Kidneys, resolving

Phlegm and Dampness and invigorating Blood.

PROSTATIC HYPERTROPHY AND THE CHONG MAI

Acupuncture Treatment for Prostatic hypertrophy

Syndrome Left Side Right Side Bilateral

Prostatic

hypertrophy

SP-4

Gongsun

P-6 Neiguan Ren-3 Zhongji ST-28

Shuidao KI-14

Siman

Ren-4 Guanyuan

LIV-3 Taichong

COMPARISON AND DIFFERENTIATION BETWEEN THE REN AND CHONG MAI

The differences may be summarized as follows:

The Ren Mai corresponds to Qi, the Chong Mai to Blood. However, the Ren Mai may

also be used in Blood pathologies, which are often due to Qi problems.

Some doctors say that the Ren Mai is responsible for pregnancy and the Chong Mai

for problems not to do with pregnancy

The Ren Mai corresponds to the Lungs (=Qi) and the Chong Mai corresponds to the

Heart and Spleen (=Blood). One would therefore use the Ren Mai more for Lung

problems and the Chong Mai for Heart and Spleen problems

The Ren Mai is used more in cases of Qi deficiency or stagnation, whereas the Chong

Mai is used more when there is an actual material accumulation (of Blood stasis,

Food or Phlegm), as well as for rebellious Qi

I choose the Ren Mai more when the pulse is Weak, Short or Fine (all signs of Qi

deficiency), and the Chong Mai when the pulse is Slippery, Full, Long, Wiry, Firm

(all signs of Excess)

The Ren Mai influences the “Small Abdomen” (Xiao Fu) i.e. the

central-lower abdominal area, while the Chong Mai influences the

“Lesser Abdomen” (Shao Fu), i.e. the lateral-lower abdominal area

To use asthma as an example, both vessels are effective in this condition; the

Ren Mai is used when the asthma is due to Lung and Kidney deficiency (the

person is often thin and the asthma is often allergic), while the Chong Mai is

more used when the asthma is due to rebellious Qi but also stagnation of

Phlegm (and therefore presents with copious expectoration, a Slippery pulse

and a thick tongue coating and the person is often overweight or robust).

Ren Mai

Chong Mai

It is in gynaecological problems that the differences between the two

Vessels are most blurred, particularly in menstrual disorders. However,

one would use the Ren Mai when the menstrual problems are caused by a

Qi disorder, and the Chong Mai when they are caused by a Blood disorder.

The Ren Mai is used more for conception, fertility, pregnancy, menarche

and menopause, and the Chong Mai more for menstruation and in

particular painful periods. The Chong Mai is the vessel to use in painful

periods

When differentiating the Ren from the Chong Mai in gynaecology, I

use the Ren Mai if the pulse is Weak or Fine and the Chong Mai if it is

Wiry or Firm.

The pulse of the Chong Mai is Firm in all three positions; also hard on

both Middle positions.

PULSE OF THE CHONG MAI

Pulse Classic (Mai Jing)

“When the pulse is Firm from the Rear to the Front position, beating straight

up and down, it indicates [a pathology of] the Chong Mai. There will be Cold

Hernial and Genito-Urinary Disorder [shan] of the chest.”

“If the pulse is hard and Full in the middle level on [both] Middle [Guan]

positions, it indicates [a pathology of] the Chong Mai. There will be

hypogastric pain radiating upwards to harass the heart, Hernial and Genito-

Urinary Disorder [Shan] with masses, miscarriage, urinary incontinence and

fullness of the hypochondrium with anxiety.”

Firm Hard and Full

12. HERBAL THERAPY

a) Herbs

Gui Ban Plastrum Testudinis.

b) Formulae

• Bie Jia Carapax Trionycis

• Gui Ban Plastrum Testudinis

• E Jiao Gelatinum Corii Asini

• Xuan Shen Radix Scrophulariae ningpoensis

• Sheng Di Huang Radix Rehmanniae glutinosae

Ye Tian Shi

Da Bu Yin Wan Great Tonifying Yin Pill.

Gui Ban

E Jiao

Bie Jia

Xuan Shen Sheng Di Huang

KI-13 QIXUE (Qi Hole)

Other names include Baomen (“Door to the Uterus”) and Zihu (“Window of

the Baby”). There are three explanations for the meaning of this name:

1. The point is situated near the opening of the bladder, hence "hole".

2. The Kidneys control the grasping of Qi and this point is the "hole" into

which Qi is anchored.

3. The Jing accumulates in this "hole".

The actions of this point are as follows.

▸ Benefits the Ren and Chong Mai

▸ Regulates the two Yin (orifices)

▸ Tonifies the Kidneys and the Jing

The indications specific to gynaecology include: irregular periods, white

vaginal discharge, Uterus Empty and Cold, Ren and Chong Mai empty.

Like the other points on the Chong Mai, KI-13 also has a dual function: it

can both supplement a Deficiency and clear an Excess.

In Empty conditions, it is probably the most important tonifying point on

the Chong Mai: it tonifies the Kidneys (Yin or Yang), nourishes the Jing,

strengthens the Yuan Qi and fills the Ren and Chong Mai.

It also strengthens the Kidney's grasping of Qi and is an important point in

treating allergic asthma from Kidney deficiency or nourishing Kidney-Yin

in menopausal problems.

In Full conditions, KI-13 Qixue is used for rebellious Qi of the Chong Mai

causing an upsurge of energy from the lower abdomen to the chest and

throat. It should be noted, however, that in such conditions it need not

necessarily be reduced: if the condition of rebellious Qi is secondary to a

Kidney deficiency and an emptiness in the Lower Burner as described

above, then this point should be reinforced.

The "Great Dictionary of Chinese Acupuncture" compares this point with

the keys of a wind musical instrument. It says that it moves Blood

through Qi (Qi being compared with the air in a wind instrument and the

Kidney points on the abdomen presumably corresponding to its keys),

and that it treats the running piglet surging upwards and the beng lou

(Flooding and Trickling) leaking downwards.1

I frequently combine this point with Ren-4 Guanyuan (through which the

Chong Mai also flows) to tonify the Kidneys, nourish the Jing and

strengthen the Yuan Qi.

1. Yang Jia San 1988 Great Dictionary of Chinese Acupuncture (Zhong Guo Zhen Jiu Da Ci Dian), Beijing

Physical Training College Publishing House, Beijing, p. 243.

KI-14 SIMAN (Four Fullnesses)

This point’s other names include Suifu (“Fu of Marrow”) and Suizhong

(“Central Marrow”). There are many explanations for the name "Four

Fullnesses":

1. "Four" because it is the fourth point after the Kidney channel enters the

trunk.

2. It lies over the bladder and "Fullness" indicates the bladder full of urine.

3. "Four Fullnesses" refers to a feeling of fullness in the abdomen radiating in

four directions.

4. "Fullness" indicates hernia for which it is used.

5. "Four Fullnesses" indicates a feeling of fullness in the abdomen from four

stagnations (of Qi, Blood, Food and Dampness).

6. The Jing of the four limbs and the hundred bones collects in the Field of

Elixir (dan tian), surplus Jing is transformed into Marrow, enters the bones and

then returns to the extraordinary vessels, Jing, Qi and Blood "fill up" in the Field

of Elixir near this point.

The actions of KI-14 Siman are as follows.

▸ Regulates Qi

▸ Treats hernia

▸ Regulates the menses

▸ Promotes fertility

Indications in gynaecology include: metrorrhagia, irregular menstruation,

retention of lochiae, vaginal discharge, infertility, lower abdominal pain.

This point can also be used both for Deficiency and Excess but more

frequently for the latter. From this point of view, KI-14 is a very important

point for stagnation of Qi and/or Blood in the lower abdomen in women. I

use it frequently in combination with the opening points of the Chong Mai

for stagnation of Qi or Blood in the abdomen causing such problems as

dysmenorrhoea, abdominal pain or menorrhagia.

Bearing in mind its name, this point is specific for a feeling of fullness of

the abdomen. As its alternative names indicate, this point can be tonified to

nourish Marrow: for this reason, it is used during and after the menopause to

prevent osteoporosis.

KI-16 HUANGSHU (Shu Point of Membranes)

"Huang" means "membranes" and "Shu" means Transporting point (as in the

Back-Shu points). The point is situated at the border between the upper and

lower abdomen and it therefore lies at the centre of the "membranes": these

include the connective tissue structures lying in the abdomen, i.e. mesentery,

omentum and fascia. This point is therefore the Shu point of these structures. It

is also the point from where the Kidney channel penetrates deeply into the

membranes.

These penetrate upwards to the chest and diaphragm and connect with the Dai

Mai. This point, being near the umbilicus which connected the foetus to the

mother, controls the origin of membranes and is like the Yuan point of all

internal organs. "Transporting point of membranes" also means that the point is

at the centre of membranes, it connects downwards with the Kidneys and

upwards with the Heart, the throat and tongue.

The actions of this point are as follows.

▸ Regulates Qi

▸ Stops pain

▸ Moistens dryness

▸ Promotes the bowel movement

▸ Regulates the Chong Mai

The main gynaecological indications are irregular periods.

Other indications, which help us to understand the nature of this

point, include umbilical pain, abdominal distension,

constipation, hernia, vomiting, diarrhoea, Cold in the Large

Intestine, feeling of "cold under the heart region".

As can be seen from the indications this point is mainly used for Full conditions

characterized by rebellious Qi in the Chong Mai: in gynaecology, principally for

dysmenorrhoea and irregular periods. However, there is a deeper significance in

that this point belongs to the Chong Mai and is situated next to the umbilicus.

Through this point, the baby's umbilical cord connects with the mother's

placenta; the Chong Mai is the precursor of all other extraordinary vessels and

therefore related to the Pre-Natal Qi. At conception, the Du, Ren and Chong

Mai are formed, representing the spark and organizing force that will give shape

to the human form.

In the foetus, the umbilicus, the Yuan Qi and the Ming Men lie on the same

energetic axis and KI-16, lying right next to the umbilicus and being on the

Chong Mai, is like a Shu point not only for the membranes, but also for all the

internal organs. Thus, this point can affect the Pre-Natal Qi, the Kidney-Jing

and the Yuan Qi.

KI-21 YOUMEN (Dark Door)

"You" means "dark" and "men" means "door". "Dark" denotes the fact

that at this point the Chong Mai goes deeper and disappears into the

chest cavity, hence into "darkness". "Door" indicates that it is the

border between the more superficial abdominal branch and the deeper

thoracic branch of the Chong Mai. "Dark" also refers to the Yin

character of this point pertaining both to the Kidney channel and to the

Chong Mai.

The actions of KI-21 Youmen are as follows.

▸ Strengthens the Spleen

▸ Harmonizes the Stomach

▸ Subdues rebellious Qi (of the Chong Mai)

▸ Stops vomiting

▸ Calms the Mind

The indications of KI-21 Youmen include palpitations, anxiety, poor

memory, abdominal fullness, and chest pain in women. The book

"Acupuncture" reports the last symptom from an old classic: this is

interesting as it confirms that this point treats the Chong Mai in women in

conditions of rebellious Qi.1

KI-21 Youmen is also compared to a door because all types of Qi go

through this point on their way up through the diaphragm: Gu Qi, Qi of the

Jing (Jing Qi), Clear Qi (Qing Qi) and Yin and Yang Qi. This point is said

to pacify the five viscera by sorting out their clear and turbid Jings.

1. Yang Jia San 1989 Acupuncture (Zhen Jiu Xue), People's Health Publishing House, Beijing, p. 361.

Thank you for attending this online course with Giovanni. Giovanni

also has several online CEU courses available, make sure you take

this opportunity to visit his websites after attending the webinar to

see all of the resources he has to offer.

www.maciociaonline.com

www.three-treasures.com

www.giovanni-maciocia.com

www.maciociaonline.blogspot.com

http://www.facebook.com/three.treasures

http://maciociaonlinespanish.blogspot.com (en Español)

http://www.facebook.com/pages/GIOVANNI-MACIOCIA-MEDICINA-

CHINA/136705379697654?v=wall (en Español)

http://twitter.com/#!/@gmaciocia

www.maciocia.com