When working with a Doctor of Traditional Chinese Medicine it doesn’t take long to hear the word “meridian” being tossed about. The meridians are fundamental pathways that display communications throughout the body. These meridians are a catch-all source to many of our physiological functions that traverse through the periphery into the limbs and extremities. The sake of this article is to dive into these peripheral meridians that are so fundamental to eastern medicine, and look at their role in regulating our circulatory and lymphatic system.
Let’s begin by quickly defining these two anatomical systems. Anatomical meaning that they’re defined structurally in terms of common functionality and cellular make-up. The circulatory system is comprised of the blood vessels and all that circulates within them under the broad term “blood”. Anatomically the blood vessels are divided into three main divisions: that which carries oxygenated blood away from the heart (arteries and arterioles), the collateral vessels which act as an interchange for nutrition (capillaries), and the vessels which carry deoxygenated and depleted blood back towards the heart (veins and venules). These vessels contain blood cells, platelets, and many specific blood-bound sugars and proteins (predominantly nutrition and immune focused proteins) all afloat within an aqueous liquid called plasma.
As already mentioned the capillaries are the site of exchange. At the exchange level these vessels are built in a way that does not allow blood cells to leave the vessel (they’re too big to squeeze out through the small perforations!), except for a special type of white blood cell class known as the monocyte which does so in response to threat/trauma - what is known as the inflammatory response. The much smaller molecules (sugars and proteins) and plasma itself are free to come and go from the blood vessel passively through the process of diffusion and osmosis.
This is where the lymphatic system comes into play being closely connected with the circulatory system. The lymphatic system, like the circulatory system is comprised of vessels called lymphatic vessels which carry lymphatic fluid away for cleaning and processing at nearby lymph nodes. Lymphatic fluid is an extracellular fluid composed of all of the permissible constituents of our blood outlined above. In addition to these permissible blood constituents, the lymphatic system also contains a large degree of waste-debris as result of our immune system doing its job responding to traumatic injury, infection, everyday wear & tear, and normal cell-death (apoptosis).
The lymphatic system functions with the assistance of the liver, spleen, thymus, appendix, tonsils, and bone marrow. The lymphatic system does not have its own built-in pump to circulate fluids like the circulatory system has the heart, instead it does so with the physical movement of the body. The pumping action created by our muscles through movement, activity and exercise is what supplies the lymphatic system with the circulation or ‘Qi-flow’ needed in order to function effectively.
Now let's talk Qi. This term Qi-flow in Traditional Chinese Medicine refers to that which makes things move, communicate, distribute and be lively. Traditional Chinese physiology describes Blood as the available circulating nutrition (oxygen, vitamins, and other sources of potential energy) required for healthy function, yet it is Qi which is responsible for the Blood's movement throughout the body. As you can see here is a great example of Qi as not a material 'thing' but rather an active quality observed and measured throughout the body in countless forms.
It is said that Qi and Blood are indivisible and that they together sustain the other. When Blood/nutrition is deficient we will begin to see the Qi/circulation become deficient, and when the Qi/circulation becomes deficient we will begin to see the Blood/nutrition soon become deficient. The reason for dividing these two aspects is so that we may achieve a more effective treatment, knowing where to place the focus in order to best address both.
This brings us into the realm of meridians as they are the all-encompassing conduits of the body’s grand Qi-flow. Broadly speaking Qi sits in the space between Yin & Yang. The meridian Qi flows within the spaces between the body's prominent physical structures. Most often being the connective tissue. Connective tissue exists throughout the body from the skin layer, to surrounding/connecting muscles, to suspending viscera, to protecting/connecting bones. We are able to tap into this meridian Qi using sensory stimulation/feedback techniques stimulating the body to best do its job. Let's now look at how TCM treats the meridians to improve the circulatory-lymphatic function.
The Inflammatory Response
The first sort of stimulation that affects the meridian qi in regulating the circulatory-lymphatic system is that which is achieved through microtrauma and the inflammatory response that follows. These selective microtraumas are dealt using a needle to physically pierce the skin and other epithelial layers. This trauma triggers the body’s non-selective immune response and what is known as acute inflammation. This creates an increase in blood flow locally, vasodilation of the vessels establishing swelling and the pooling of platelets plus a large variety of immune cells. Ultimately this process leads to repair, proliferation, and the elimination of cellular debris from broken down pathogenic microbes and necrotic tissues.
Working with the non-selective immune response gives us control over the distribution of inflammation. Local needling can be used to increase circulation in a degenerated or partially-healed area, boosting the body's ability and extending the time-of-effect in which it is repairing and recovering. On the other hand this technique can be used to minimize the excessive swelling and inflammation that occurs with traumatic injury and is often the source of extended pain, dysfunction and slower healing. This local swelling is minimized by activating the inflammatory response at the extremities, beyond the injured site. This technique distributes the body's inflammatory energy throughout the affected meridian, clears heat from the meridian, and opens the meridian by establishing awareness all the way down the channel (more on this to come below!)
This same sort of technique can also be used to guide the inflammatory energy out and away from the core in cases where the viscera are showing signs of heat particularly ulcers and all variations of '-itis': gastritis, colitis, hepatitis, appendicitis, and so on. This is done through strategically applying microtrauma to the meridian(s) associated with the affected organ. And one more, there is the technique known as the surrounding method (see image on the left), where a localized infection for example, is able to be contained by preemptively activating the inflammatory response in the areas surrounding the active infection site. This sort of technique can be seen as increasing the armies fortification in the areas that the enemy is likely to invade next. It works great for shrinking rashes, healing bug bites, and all-around optimization of our circulatory-lymphatic activity!
The Mind-Body Connect
Just like the setting off the inflammation cascade, regulating the nervous system can also be achieved through the stimulus produced by an acupuncture needle. Of course there is the entire field of how acupuncture directly modulates the anatomical nervous system. This plays a incredible role in breaking down materialized sources of dysfunction in movement, posture, and sense of self that disrupt the healthy functioning of the circulatory-lymphatic system. In this field there is also the recognition of acupoints which show a direct effect in activating the blood flow systemically. We will save this topic for a future post (tit. Qi Meridians & The Nervous System) as it is quite elaborate on it's own. For the remainder of this article we will focus in on the non-substantial aspects belonging to our subjective sensations, not yet fully encapsulated by the current neurological understanding.
This takes us into the realm of psychosomatic conditions and those subjective sensations that are felt but for some reason remain physically undetectable with modern tests and diagnostics. We can think of conditions like fibromyalgia, restless leg, psychically-induced paralysis, post-injury guarding and compensation, and so on. These conditions can be explained neurologically to some extent, but there still remains many empirical unknowns.
Traditional Chinese Medicine doesn't require a physical understanding and anatomical pathogenesis in order to effectively treat these sorts of conditions. Instead it looks at the mind and body as an inherent whole, recognizing that the mind, although not fully understood, has the ability to influence Qi, and Qi has the ability to influence the physical. This is seen in the way that we store different emotions within the physical body each in their own common ways. Even a dog clenches its jaw in response to what TCM refers to as Wood Element stress (anger, hostility, frustration). When we adopt psycho-emotional excesses/imbalances we adopt postures and a ‘sense of self’ in the ‘ethereal’ body that disturbs the way we position and move in our physical body. These display themselves throughout their corresponding meridians.
We also see that physical trauma can store itself in the affected areas, and even after the damaged structures have physically healed we still can see locked-in insecurities and guarded compensations that remain . On the psycho-emotional front we see an abundance of sound statistical studies showing the effects of childhood trauma and insustainable behavioral tendencies progressing over time into true physical disease. These include serious diseases like MS, cancer, strokes, and parkinsons. This is a realm that ultimately has direct effect on the circulatory-lymphatic system, as well as indirectly via the postural/movement deficiencies that accompany.
The connective tissue is rich in a collection of sensory receptors, of these our interoceptors are the prime focus as they are what will ultimately influence the other receptors like our proprioceptors, nociceptors, and baroreceptors. Interoceptors are popularly known for their role in unconsciously receiving stimuli from the gut and internal organs, but for some reason we also see high concentrations of interoceptor nerve endings existing in the protective-Wei level (skin) and the meridian Qi level (superficial fascia - loose connective tissue). Modern research is beginning to show that these peripheral interoceptors may be closely related to our ‘sense of self’, ‘sense of purpose’, and one’s psycho-emotional well-being - particularly how we respond emotionally to touch.
To release obstructions in this ‘ethereal’ body is what TCM refers to as treating the spirit. In some cases the needle is inserted so superficially that it would seem as though it could possibly be doing nothing at all, but it is this gentle approach that is highly effective in connecting the mind with the body and allowing the body to remain free and open to the Qi freeflow. One could think of this method as an assistive modality to the power of relaxation and intent achieved through Qigong practices. Using a guide tube and forcefully tapping the acupuncture needle in can disturb the spirit and the acupuncturists ability to work with and influence it. This sort of forceful guide tube needle bashing and reckless IMS-style manipulations are still effective in treating the physical (nervous system, muscles, activating the inflammatory response, etc.) but not the spirit.
As we know with acupoints many of them have a large handful of functions, but if we are to have good skill in treatment we have to understand how to best stimulate the points so to achieve the specific function we desire. The spirit is incredibly light and immaterial, when treating the spirit directly we must also do so in an extremely delicate and light way. This is yet another reason why the acupuncturist is that much more skilled and versatile in the realm of needling.
When these spirit-level meridian-obstructions occur they directly affect the Qi's ability to move and free-flow. This disturbs our blood's ability to circulate well through the vessels leading to anything from cold hands & feet, to raynauds, chronic venous insufficiency, and both high or low blood pressure - depending on the nature of the obstruction.
On the lymphatic front, spirit-level meridian-obstructions affect our ability to be postured and move well. It also affects our passion and drive in wanting to both move well & move often. As we know, daily full-body activity is necessary to healthy lymphatic drainage. Lack of activity puts a burden on our immune system and makes it work a lot slower. In cases where specific areas become guarded, the chest posture collapses in, low back has excessive arching, or the muscular system becomes caught in imbalances of hyperactivity and hypoactivity, we see localized inefficiencies in the lymphatic system as well alongside this systemic lymphatic burden. Emotional imbalances can also stress the nervous system and put it into a protectionist-survival mode. This affects the body's ability to adapt and inhibits our immune system. We can see cases of immuno-suppression as well as immuno-hyperactivity, meaning the body becomes extremely defensive and reactive to the smallest of aggravators including autoimmune dysfunction.
To sum it all up, these pathways of insubstantial communication have a strong overlap with, and play a huge role in influencing the circulatory-lymphatic system. Using traditional Chinese medical understandings and techniques can work wonders in optimizing these functions, and often in the most simple and non-invasive of ways. I'll always finish by emphasizing the importance of scheduling a visit with a knowledgeable doctor of Traditional Chinese Medicine if you feel as though this is a area that could use improvement in your life. We visit a doctor of TCM not only for the acupuncture treatment but also for their provided insight and education regarding optimization of movement, diet, mindset, and other aspects to lifestyle to best support your unique condition influencing your circulatory and lymphatic health.
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