Ning Ma Clark， Strider

“It is all about mastering skin, muscle, sinews and fascia, and vessels; when the function of the Channels and Collaterals is discussed”. Channels and Collaterals have broadly been accepted as the translation of JingLuo (经络) in English. Channels and Collaterals are the structural network of body tissues when skin (皮), muscle (肉), vessels (脉), sinew and fascia (筋) are connected in the body. “Skin, muscle, sinew and fascia, and vessels respectively have their own locations, structures, functions, and diseases, but they all support and benefit each other (in the network). Their diseases have to be treated respectively”. Even though the terms of Channels and Collaterals had not been mentioned in the statement above, the way of the wording and expression are the exact same in the two sentences. Therefore, Channels and Collaterals are unified body structures made by tissues like skin, muscle, vessels, sinew, and fascia. They also remain independent in body composition regarding the perspectives of anatomy, physiology, pathology and treatment of diseases.

“In view of movements contrary to and in accordance with the Five Structures (五体) , it apples to what is the size difference in the bones and joints, whether the muscle presents as firm or brittle, whether the skin presents as thick or thin, whether the blood presents as clear or turbid in quality, whether the qi movement presents as smooth or rough, whether the vessels present as long or short, whether the blood presents are rich or poor in quantity, and how many major passageways in the Channels and Collaterals ”. Five Structures are named in order to group structural tissues like skin, muscles, bone, vessels, sinew and fascia in the statement above. The paragraph can be interpreted as: When we talk about Channels and Collaterals, it actually is discussing how the Five Structures build the body and how the Qi and blood (气血) move in the body. Therefore, Channels and Collaterals are not only a structural composition, they are also a substantial assembly.

The Yellow Emperor’s Inner Cannon endued a two-fold meaning to Channels and Collaterals: The structural meaning and the substantial meaning. In view of the structure, Channels and Collaterals are not only the connection of the Five Structures, but also developed three new functional systems. They are the JingJin (经筋), JingMai (经脉) and PiBu (皮部). Bone was not mentioned in the Channels and Vessels because it only applies to its attachment to the sinews and fascia. It did not physically participate in the circulation of Qi and blood. In view of the body tissue, Channels and Collaterals not only contain tissues 〖JP3〗like skin, muscle, bone, vessels, sinew and fascia, but also include Qi and Blood which circulate in the Channels and Collaterals. It is focused on rebuilding the structural model in my book of “Anatomy of Channels and Collaterals”.

The structural perspective of the Channels and Collaterals

Fascia and Sinew Chains (JingJin) is a structural complex

“The head, the face and the entire body are tied to bones and connected through sinew and fascia”. The human body is connected by fascia. Fascia connects all different structural tissues in the horizontal and vertical planes. It connects inwardly to the bone and outwardly to the skin in the horizontal plane, while muscles, vessels and nerves are wrapped by fascia and kept in the middle. Modern medicine divides the body tissues into different functional systems, such as the muscular system, the blood vessel system, the nervous system by the separations made by fascia. Traditional Chinese Medicine (TCM) focused on the vertical connection of the structural tissues. Fascia connects all different tissues such as muscles, vessels and nerves into a chain. The Yellow Emperor’s Inner Cannon named it JingJin, and translated it as Fascia and Sinew Chains, or simply the Chain.

Fascia plays the most important role in the Fascia and Sinew Chains. Fascia is one of four body tissues in the group of the Sinew and Fascia. They are the fascia, tendons, ligaments and even the nerve stems. They are all fibrous in nature. Fascia wraps different structural tissue around and connects them together at the same time. It must be noted that muscles, vessels and nerves are only the carrier of the fascia in the Chain. “All sinew and fascia are belonging to the joints”. The place where the tendon and fascia attach to the joints or their ligaments is called the “node” of the Chain. This attachment makes it possible to view the vessels and nerves as “a section” of the Chain to match the layout of muscles. This attachment also makes it became possible to allow the fascia to switch among different types of the structural tissues. It also allows the Fascia and Sinew Chains to change the direction. In the Yellow Emperor’s Inner Cannon, the purpose of allowing fascia to switch among different carriers is to create a passageway for qi and blood to travel. It is not for the purpose of serving as a muscle strength line.

There are two kinds of branches in the Fascia and Sinew Chains. This notion may be contrary to the understanding of scholars from ancient times to the present day. They are the connecting branches (ZhengBie 正别) and the communicating branches (JingBie 经别). The Connecting Branch physically bridges the Fascia and Sinew Chains connecting to organs they belong to and the organ they are associated with. Therefore, the connecting branches have three feathers: 1) The structural tissue of the Connecting Branches have the capacity to go into the body cavity. 2) The branch with Yin nature always follows it’s associated yang branch. 3) The branch reaches the organ it belongs to first and then connects to the organ it is associated with. The space surrounding the Connecting Branches normally serves as the path in the section inside the 〖JP2〗body of the Channels and Vessels. The communicating branches physically 〖JP4〗connect between the Yin and Yang related Chains. This is achieved by utilizing the structures such as muscle, nerve and vessels; which they can physically go through or step across the intermuscular septum. The space surrounding the Communicating Branches allows exchanges of qi and blood in the Yin and Yang correlated Channels, which are located in the different osteofascial compartments.

Channels and Vessels (JingMai) is the passageway of the Qi and Blood.

“JingMai is the structure to circulate the blood and Qi (气) , and balance Yin and Yang”. JingMai is translated as Channels and Vessels in English, or simply the Channel. It is a structural unit including vessels and interstitial spaces inside the body that circulates blood, YingQi (营气), and Weiqi (卫气) . “YingQi travels inside of the vessels, WeiQi spreads outside of the vessels”. There are two separated spaces in the Channel; Therefore, it presents as a casing model with double membranes. A vessel-either a blood vessel or a lymphatic vessel, is in the center of the Channel. It is the passageway for the passage of blood and YingQi. The wall of the blood or lymphatic vessels serve as the inner membrane of the Channel. The outer membrane is made of fascia and the intermuscular septum, such as the neurovascular bundle or the sheath to form the osteofascial compartment. The space between the inner and outer membranes is called JingShui (经水) . This is translated as Water Channel. It is filled up with interstitial tissues, and allows WeiQi and body fluids to move in the body. It is the key factor in determining the types of Channels and Vessels by whether there is a complete existing outer membrane. When a section in the Channel has a complete outer membrane, it creates an enclosed structure of the Channels and Vessels. However, when there is no outer membrane existing in the section, it leads to the Channel becoming an open structure. This makes Channel Water have no physical border. It also allows WeiQi and the body fluids in different Channels to merge together. The passageway of the Channels and Vessels is continued in switching between the section of the enclosed structure and the section of the open structure.

Zhao had mentioned there are two main components in the Channels and Vessels: The vessel and the Chain. Vessels are the core structure of the Channel. When the vessel exists, the Channel performs the full function of transporting the blood and Qi. Whether it is in either a closed or open structure when the vessels are absent. The Fascia and Sinew Chain is only a structure in the channel. In that circumstance, Channels and Vessels are only able to transport WeiQi and the body fluids in the surrounding space of the Chain. Therefore, the minimal functionality of the Channels and Vessels is to transport the WeiQi and the body fluids.

There are branches in the system of Channels and Vessels. It is translated as the Communicating Channels (络脉). It usually utilizes the space surrounded the communicating branches of the Chain to exchange Qi and blood between the Yin and Yang correlated Channels.

Section of the Shin (PiBu) is the projection of the Channels and Vessels on the skin.

Skin is the barrier of the human body. Skin is understood as a complex structure, including tissues like epidermis and dermis, subcutaneous tissue, hair, and sudoriferous glands. The subcutaneous tissue is called CouLi (凑理). There are blood vessels in it. Some of them become the subcutaneous veins. “Puncture the blood vessel on the section of the skin and let the blood out.” The Yellow Emperor’s Inner Cannon called the subcutaneous vein “FuLuo (浮络).” “WeiQi is the valiant Qi from water and grain, which is swift and smooth in movement. It cannot enter vessels, but it flows in the skin and intermuscular space.” The Yellow Emperor’s Inner Cannon recognized WeiQi traveling in the structure of the skin. When skin is considered as a standalone structural tissue in the Five Structures, it has the full functions of the Channels and Vessels to circulate Qi and blood. Therefore, skin itself can be considered an extension of the Channels and Collaterals.

Skin has been virtually divided into sections in both TCM and modern medicine. Modern medicine divides the skin partition according to the cutaneous nerves and its segmental distribution. TCM divides the skin according to the passageway of the Qi and blood under the skin layer. The Yellow Emperor’s Inner Cannon called it PiBu, which is translated as Sections of the Skin, or simply the Section. TCM believes the nature of the Qi and blood in the Section of the Skin is the same as the Qi and blood in the Channels and Collaterals which the section belongs to. In the area especially in the extremities, Sections of the Skin are mapped by the distribution of the subcutaneous veins. In that area, there are no visible subcutaneous veins, and the section is mapped by the projection of the Channel from inside the body. Therefore, “All the subcutaneous vessels and twelve Channels are the principle to set up the partitions of the skin.”

Substantial perspective of the Channels and Collaterals

Histology believes all human structures derive from four types of tissues: epithelial tissue, muscle tissue, nervous tissue, and connective tissue.

Connective tissue is further divided into three groups: blood and lymphatic fluid, bone and cartilage, and connective tissue proper. Connective tissue proper is further divided into dense connective tissue, loose connective tissue, reticular tissue and adipose tissue.

Dense connective tissue can be divided into dense regular connective tissue, dense irregular connective tissue and elastic tissue. While loose connective tissue consists of cells, fiber and matrix.

Matching the Five Structures, Qi and blood under the scope of the Channels and Collaterals to the classification in histology, we found: Muscle in TCM and modern medicine are the same. Skin and Vessels are made by multi tissues, but their functional layer is endothelium. Therefore, Skin and Vessels belong to the epithelial tissue. “At the beginning of the embryo, the blood vessel is only made by the endothelial cell. Later it is added on the muscle tissue and connective tissues on the blood vessel wall ” . Sinew and Fascia in TCM are covered by two subcategories in histology. Fascia, tendons and ligaments all belong to the dense connective tissue, but nerve has its own category in histology. Bone of the Five Structures matches bone and cartilage. Blood and YingQi in the Channels and Collaterals match Blood and lymphatic fluids. They are all the main components of the connective tissue. While WeiQi and body fluids in the Channel are composed of cells and matrix of the loose connective tissue. Therefore, the classification of The Five Structures, and Qi and blood in the Yellow Emperor’s Inner Cannon has a perfect match with the 4 categories of tissue in histology. They just stand on different angles, using different languages.

Conclusion

One day we may prove the structure and system of the Channels and Collaterals with anatomic evidence. It would be proof that ancient sages who taught the Yellow Emperor’s Inner Cannon, had mastered the mystery of human embryology and anatomy. They discovered how the human body is built and how qi and blood are circulated. It is the greatest contribution not only to the theory of Channels and Collaterals, but also to the understanding of human life. It demonstrated that Traditional Chinese Medicine had already become an advanced, and complete medical system 2000 year ago.

Author information:

1. 馬寧，博士， 針灸基石紐約中心。30 E.40th Street, Suite 902,New York, NY 10016 USA [email protected]

2. 克拉克·斯特里德，L.Ac.英文编辑。Clark， Strider， L.Ac. English Editor.