Channel pattern identification

The process of diagnosing a morbid condition as a disease pattern of a channel or channels and their network vessels.

Channel pattern identification is the diagnostic process of assigning symptoms to the disturbances of a specific channel. It involves using knowledge of the channel pathways and their connections with the bowels and viscera to identify patterns associated with the channels.

The channels can transmit disease from one part of the body to another, notably from the body's surface to the bowels and viscera. When external evils invade the body and channel qì fails to resist them, they can penetrate the bowels and viscera. Conversely, when illness arises among the bowels and viscera, it can be transmitted through the channel system to affect the exterior. When such processes occur, which channel or channels are affected can be determined by the location of pain, discomfort, or loss of function within the channel system, particularly in its superficial pathways, and provide clues to which bowels or viscera may be affected. The Sù Wèn (Chapter 22) states, In liver disease, there is pain under the rib-side stretching into the lesser abdomen… In lung disease, there is cough, panting, and counterflow qì, with pain in the shoulder and back. Clues may be provided by not only the general discomforts along the channel pathways but also at specific points. For example, palpatory tenderness or other anomalies detected at back transport (bèi shù) points may indicate disease of the associated bowel or viscus.

Channel pattern identification is especially important in diagnosis for acumoxatherapy and tuī-ná but is also used in diagnosis for medicinal therapy.

Twelve Channel Patterns

The twelve channels comprise the three yīn channels of the hands and feet and the three yáng channels of the hands and feet.

Overview of Signs

Signs reflect local morbidity, morbidity in the associated bowel or viscus, or morbidity in the exterior-interior related channels.

Channel patterns are mostly related to the channel pathways: For example, if external evils obstruct the foot greater yáng (tài yáng) bladder channel, there is pain in the head, nape, back, and outer malleolus and loss of use of the little toe. When external evils obstruct the hand yáng brightness (yáng míng) large intestine channel, there may be pain, wilting or impediment, in the lateral aspect of the upper limbs, sometimes preventing the patient from lifting the arm or paralyzing the middle finger.

The bowel or viscus to which a channel homes may be affected when the channel is obstructed: For example, the hand greater yīn (tài yīn) lung channel is affected by an external evil, we may see signs of lung qì ascending counterflow, such as cough, panting, pulmonary distension, fullness in the chest, or sore throat, as well as signs of channel obstruction such as pain in the supraclavicular fossa, shoulders, back, and inner side of the upper arm.

One channel may affect its exterior-interior partner or other channels: The channels are all connected, allowing the circulation of qì and blood. The yīn channels home to the viscera, while the yáng channels home to the bowels. For example, when an external evil obstructs the foot greater yīn (tài yīn) spleen channel, there may be stomach signs such as pain in the stomach duct or vomiting after eating. When evil obstructs the foot lesser yīn (shào yīn) gallbladder channel, there may be rib-side pain and sighing, which are signs associated with the foot reverting yīn (jué yīn) liver channel, as well as gallbladder signs, and even spleen, stomach, lung, and kidney signs, such as counterflow retching, food diarrhea (飧泄 sūn xiè), dry throat (嗌干 yì gān), enuresis, and dribbling urinary block.

Signs by Channel

See channel pattern identification. Examples of signs associated with each channel as described in the Nèi Jīng are as follows:

Hand greater yīn (tài yīn) ( tài yīn) lung channel: Pulmonary distension; cough; fullness and oppression in the chest; pain in the supraclavicular fossa; shoulder and back pain or cold in the shoulder and back; scantness of breath; aversion to cold as if after a soaking with heat effusion; spontaneous sweating; pain in the anterior aspect of the upper arm and arm.

Hand yáng brightness (yáng míng) large intestine channel: Toothache; swollen neck; throat impediment; yellowing of the eyes; dry mouth; sniveling nose; nosebleed; pain in the anterior aspect of the shoulder and upper arm; and pain in finger next to the thumb (index finger).

Foot yáng brightness (yáng míng) stomach channel: Heat effusion more pronounced in the anterior aspect of the body; pain in the nose; sniveling nose; nosebleed; toothache; deviation of the mouth; throat impediment; swollen neck; pain and swelling of the knee; pain along pathway in the region of the breasts; qì street; thigh; exterior aspect of the lower leg; and dorsum of the foot; and loss of use of the middle toe.

Foot greater yīn (tài yīn) spleen channel: Stiff tongue; vomiting after eating; stomach duct pain; abdominal distension and frequent belching; relief after defecation and passing of flatus; heavy body and limbs; immobility of the limbs; inability to eat; heart vexation; pain and tension below the heart; sloppy stool; diarrhea; concretions and conglomerations; jaundice; inability to lie flat; swelling on the inner side of the thigh; and loss of use of the great toe.

Hand lesser yīn (shào yīn) heart channel: Dry belching; heart pain; thirst with desire to drink; yellowing of the eyes; rib-side pain; anterior aspect of the inside of the arm; and heat pain in the palms.

Hand greater yáng (tài yáng) small intestine channel: Sore throat and swelling under the chin; inability to look behind; pain in the shoulder; pain in the upper arm; deafness; yellowing of the eyes; swelling of cheeks; pain in the neck, under the cheek, shoulder, upper arm elbow, or posterior lateral face of the arm.

Foot greater yáng (tài yáng) bladder channel: Heat effusion and aversion to cold; nasal congestion; headache; eyes as if fit to burst from their sockets; nape painful as if to be prized off; spinal pain; lumbus painful as if fit to break; inability to bend the thigh; back of the knee as if bound; calves as if fit to split; and loss of use of the little toe.

Foot lesser yīn (shào yīn) (tài yīn) spleen channel: Hunger with no desire to eat; face black as lacquer and emaciated as firewood; coughing and spitting with blood; severe panting; heart region feeling empty as if suspended and as if hungry.

Hand reverting yīn (jué yīn) pericardium channel: Heat in the palms; hypertonicity of the arm; swelling of armpits in severe cases with propping fullness in the chest and rib-side; great thudding in the heart; red face and yellow eyes; incessant laughter; heart vexation; and heart pain.

Hand lesser yáng (shào yáng) triple burner channel: Deafness; pain in the heart region and rib-side; swollen throat and throat impediment; sweating; pain in the canthi; cheek pain; pain behind the heart; in the shoulder, upper arm, elbow, and forearm; loss of use of the little finger and second finger.

Foot lesser yáng (shào yáng) gallbladder channels: Bitter taste in the mouth; frequent sighing; pain in the heart region and rib-side with inability to turn sides; in severe cases; slightly dusty face; limbs without luster; heat on the outer sides of the feet; headache; pain under the chin; painful swelling in the supraclavicular fossa; armpit swelling; saber and pearl-string lumps (马刀侠瘿 mǎ dāo jiā yǐng); sweating and quivering with cold in malarial disease; pain in the chest, rib-side, thigh, outer side of the knee to the lower leg, Severed Bone (GB‑39), and outer malleolus; and loss of use of the toe next to the little toe.

Foot reverting yīn (jué yīn) liver channel: Lumbar pain with inability to bend forward and backward; in severe cases dry throat; fullness and the chest; counterflow retching; food diarrhea (飧泄 sūn xiè); foxlike mounting; enuresis; and dribbling urinary block; and swelling of the lesser abdomen in women.

Eight Extraordinary Vessels

The eight extraordinary vessels have the function of connecting and integrating the twelve channels and of regulating the yīn, yáng, qì, and blood of the organism. Of them, the governing, controlling, thoroughfare, and girdling vessels are of greatest significance in physiology and pathology.

Governing (dū), controlling (rèn), thoroughfare (chōng), and girdling (dài) vessels are mostly associated with reproductive problems.

• The governing (dū) vessel runs up the middle of the back of the body and is the sea of the yáng vessels and controls the yáng of the entire body.
• The controlling (rèn) vessel runs up the middle of the front of the body, is the sea of the yīn vessels, and supports the yīn of the entire body.
• The thoroughfare (chōng) vessel runs on both sides of the controlling vessel, is the sea of the twelve channels, and commands the qì and blood of the channels.
• The girdling (dài) vessel ties all the vessels together around the waist, allowing the twelve channels and the governing, controlling and thoroughfare vessels to communicate. It regulates their qì and blood and governs reproduction.

The first three of these, the governing (dū), controlling (rèn), thoroughfare (chōng) all originate in the smaller abdomen and are intimately related to the liver, kidney, and life gate, as well as being closely associated with the foot yáng brightness (yáng míng) stomach channel and the foot lesser yīn (shào yīn) kidney channel. Thus, they are important to the health of the true qi of both earlier and later heaven and in particular reproduction.

In clinical practice, interventions to regulate the thoroughfare (chōng) and controlling (rèn) vessels treat menstrual irregularities, infertility, and habitual miscarriage, while warming and nourishing the governing (dū) and controlling (rèn) vessels treat reproductive function disorders, including those of males such as impotence, seminal emission, premature ejaculation, and male infertility.

Yīn springing (yīn qiāo) and yáng springing (yáng qiāo) vessels: The yīn springing vessel runs from the inside of the legs to the head and face, while the yáng springing vessel runs from the lateral aspect of the legs to the head and face. Together, they facilitate communication between the yīn and yáng of the entire body and the normal movement of the limbs. In pathology, they are associated with wind stroke hemiplegia, wind-damp impediment pain, rigidity of the lumbus and back, and with numbness and tingling of the extremities.

Yīn linking (yīn wéi) and yáng linking (yáng wéi) vessels: These two vessels are associated with pain and with cold and heat.

• The yīn linking vessel originates from the intersection of all the yīn vessels, ascending the abdomen, and chest, meet with the foot greater yīn (tài yīn) channel. It links all the yīn channels. It is associated with interior conditions, such as heart, chest, stomach, and anterior yīn pain.
• The yáng linking vessel originates from the yáng intersection, passes through the rib-side and shoulder, and meets with the governing (dū) at GV‑16 (fēng fǔ, Wind House). It links all the yáng channels and, in pathology, is associated with exterior patterns, aversion to cold and heat effusion, and lumbar pain.

The Fifteen Network Vessels

The fifteen network vessels are the network vessels of the twelve channels, the two network vessels of the governing (dū) vessel, and the great network vessel of the spleen. They spread qì and blood to provide nourishment for the whole body. They reach the bowels and viscera in the inner body and the skin and flesh in the outer body, thus providing communication between the interior and exterior.

The major network vessels have the same significance as their channels: For example, the hand reverting yīn (jué yīn) pericardium channel follows the channel pathway upward to net with the heart. Its repletion sign is heart pain while is vacuity sign is heart vexation, just like the main channel pathway.

Major network vessel signs are often accompanied by exterior-interior partner channel signs: The major network vessels provide communication between exterior and interior. The network vessels of the yīn channels communicate with the vessel with which it stands in exterior-interior relationship, while those of the yáng channels communicate with their partner among the yīn channels. For example, the network vessel of the foot yáng brightness (yáng míng) stomach channel (ST‑40, fēng lóng) can manifest as stomach channel signs, such as swift digestion and rapid hungering, abdominal distension and pain, vomiting, and throat impediment, as well as in facial puffiness, swelling of the limbs, and generalized heaviness, which are signs associated with the foot greater yīn (tài yīn) spleen channel. There may also be signs of the spleen failing to control the blood, such as flooding and spotting or menstrual irregularities.

The color and condition of the flesh along the major network vessel pathways reflect the state of the channel and its bowel or viscus: For example, when the network vessels appear a pale green-blue, this is cold. When they appear yellowish-red, this is heat. When the network vessels are long and bulge up, this is evil qì repletion. When they are short and sunken, this is right qì vacuity.