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The Treatment of the Yin and Yang Qiao Mai, Yin and Yang Wei Mai and Dai Mai

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The Treatment of the Yin and Yang Qiao Mai, Yin and Yang Wei Mai and Dai Mai THE TREATMENT OF THE YIN AND YANG QIAO MAI, YIN AND YANG WEI MAI AND DAI MAI Copyright Giovanni Maciocia YIN AND YANG QIAO MAI 阴 阳 跷 脉 YIN QIAO MAI PATHWAY FROM CLASSICS Nan Jing, Chapter 28 “The Yin Qiao Mai starts from inside the heel, goes around the internal malleolus and rises up to the throat going past the Chong Mai.” Ling Shu, Chapter 17 “The [Yin] Qiao Mai separates from the Kidney channel and originates from behind KI-2 Rangu and flows up to the internal malleolus. It rises on the inner thigh to the genitals. Then it rises inside the chest and joins with ST-12 Quepen coming to the area in front of ST-9 Renying entering the cheekbone and reaching BL-1 Jingming.” Ling Shu, Chapter 21 “The Bladder channel passes through the occiput and enters the brain: it belongs to the root of the eyes and it is called Eye System...In the brain, it divides into two vessels that become the Yin and Yang Qiao Mai. The Yin and Yang Qiao Mai cross over each other, the Yang entering the Yin and the Yin coming out into the Yang, crossing at the inner corner of the eye.” Li Shi Zhen “The Yin Qiao Mai starts inside the heel behind KI-2 Rangu, goes to KI-6 Zhaohai, up to the internal malleolus and then 2 cun up to KI-8 Jiaoxin which is its Accumulation point [Xi-Cleft point]. It then ascends along the inside of the leg and enters the genitals. It proceeds upwards and enters inside the chest, it connects with ST-12 Quepen it emerges in front of ST-9 Renying, reaches the throat where it crosses with the Chong Mai, it then reaches the inner corner of the eye.” Citing Zhang Zi Yang (Song dynasty), Li Shi Zhen: “The Yin Qiao Mai reaches the area in front of the coccyx and below the scrotum [i.e. perineum].” YIN QIAO MAI Originates inside the heel on the medial side, goes to KI-2 Rangu, ascends to the internal malleolous and then to KI-8 Jiaoxin •It rises on the inner leg and thigh to reach the genitals It ascends the abdomen and chest and connects with ST-12 Quepen It goes up to the throat connecting with ST-9 Renying and then to the eye at BL-1 Jingming where it meets the Yang Qiao Mai. CLINICAL APPLICATIONS 1. THE YIN QIAO MAI AND THE EYES Because of its relation with the eyes, the Yin Qiao Mai can be used in disturbances of sleep, whether insomnia or somnolence. Its classical indication is a tendency for the eyes to want to close and therefore somnolence. Ling Shu , Chapter 21 “If the Yin Qiao Mai is in Excess, the eyes want to close.” The tendency for the eyes to close is due to an Excess of Yin in the eyes. In this context, it is often used in conjunction with the Yang Qiao Mai. In cases of somnolence, the Yin Qiao Mai is drained (by reducing KI- 6 Zhaohai) and the Yang Qiao Mai is tonified (by reinforcing BL-62 Shenmai), together with BL-1 Jingming. However, the Yin Qiao Mai is used also for insomnia in combination with the Yang Qiao Mai. In cases of insomnia, the Yin Qiao Mai is tonified (by reinforcing KI-6 Zhaohai) and the Yang Qiao Mai drained (by reducing BL-62 Shenmai), together with BL-1 Jingming. In both somnolence and insomnia, the point BL-1 Jingming can be added to establish a connection between the Yin and Yang Qiao Mai, so that Yin and Yang energy in the eyes can be balanced. Finally, although somnolence (the symptom of the Yin Qiao Mai) is caused by an Excess of Yin in the eyes, the Yin Qiao Mai carries Yin Qi to the eyes and this may also be deficient. Ling Shu , Chapter 23 “Redness and pain of the eye starting from inner corner is due to the Yin Qiao Mai.” 2. THE YIN QIAO MAI AND WEI SYNDROME The Yin Qiao Mai can be used in certain cases of Atrophy Syndrome (Wei Syndrome), when the muscles of the inner aspect of the legs are tight and the foot turns inwards, partly because the outer leg muscles are slack. Neurological problems like sequelae of polio. This makes walking very difficult and a person prone to tripping. The Yin Qiao Mai's opening and coupled points can be used to balance the tension of the inner and outer leg muscles. To relax the muscles of the medial side of the leg, we need to reduce the Yin Qiao Mai by reducing KI-6 Zhaohai and KI-8 Jiaoxin bilaterally. 3. ABDOMINAL PAIN The Yin Qiao Mai extends its range of action to the abdomen, and can be used in Full patterns of the Lower Burner in women, for such symptoms as abdominal distension, abdominal masses, difficult delivery or retention of placenta, all from stagnation. However, the Yin Qiao Mai is chosen only when the abdominal symptoms are unilateral. In my experience, the Yin Qiao Mai can be used to treat adhesions following surgery. When I use the Yin Qiao Mai to treat unilateral abdominal pain, I deviate from my rule of using the opening point according to sex, i.e. left in men and right in women. When I treat unilateral abdominal pain, I use the opening point of the vessel on the side of the pain and its coupled point on the opposite side. For example, in case of left-side unilateral abdominal pain in a woman, I would use KI-6 Zhaohai on the left (normally, when used according to sex, I would have used this point on the right side), and LU-7 Lieque on the right. Right LU-7 KI-6 Left The Yin Qiao Mai can be used also for abdominal masses but, again, when these are unilateral. In the treatment of abdominal masses there is an overlap between the Ren, Chong and Yin Qiao Mai. The Yin Qiao Mai is used for abdominal masses that may be from Qi stagnation, Blood stasis or Phlegm: in terms of location, it is especially used when the mass is in the lateral abdomen and is unilateral. The classical indications for the Ren Mai include abdominal masses in women but of the Ju type (of Ji Ju) or Jia type (of Zheng Jia). Therefore this vessel can be used for abdominal masses from Qi stagnation especially in women and especially if they are central. The Chong Mai is the Sea of Blood and is particularly indicated for abdominal masses from Blood stasis; in terms of location, it is especially indicated when the masses are not central (as for the Ren Mai) but lateral (whether unilateral or bilateral). Abdominal masses are called Ji Ju [积 聚]. Ji indicates actual abdominal masses which are immovable; if there is an associated pain, its location is fixed. These masses are due to stasis of Blood. I call them "Blood masses". Ju indicates abdominal masses which come and go, do not have a fixed location and are movable; if there is an associated pain, it too comes and goes and changes location. Such masses are due to stagnation of Qi. I call them "Qi masses". Actual abdominal lumps therefore pertain to the category of abdominal masses and specifically Ji masses, and are due to Blood stasis. I call them “Blood masses”. Another name for abdominal masses was Zheng Jia [癥瘕], Zheng being equivalent to Ji, i.e. actual, fixed masses and Jia to Ju, i.e. non-substantial masses from stagnation of Qi. Zheng Jia is normally used in referring to abdominal masses that generally occur only in women; but they do occur in men as well, though rarely. The “Su Wen” in chapter 60 says: “Diseases of the Ren Mai...in women are masses below the waist.” In this context, the “Su Wen” uses the term Jia-Ju, i.e. non- substantial masses from Qi stagnation. ABDOMINAL MASSES 积 聚 JI JU 症 瘕 ZHENG JIA 积 Ji 聚 Ju Masses from Blood stasis 症 Zheng Masses from Qi stagnation 瘕 Jia 4. THE YIN QIAO MAI IN URINARY PROBLEMS The Yin Qiao Mai can be used to treat urinary problems. Again, I would use it for urinary problems from Full conditions such as Qi stagnation, Dampness or Blood stasis in the urinary passages. The main symptoms that this vessel treats are therefore hypogastric distension and pain, urinary difficulty, urinary retention, blood in the urine. When using the Yin Qiao Mai for urinary problems I would use its opening and coupled points (KI-6 Zhaohai and LU-7 Lieque) together with KI-8 Jiaoxin, SP-9 Yinlingquan, LIV-5 Ligou and SP-6 Sanyinjiao. 5. THE YIN QIAO MAI IN OBSTETRICS AND GYNAECOLOGY The Yin Qiao Mai is used in obstetrics especially for problems after birth, such as abdominal pain, retention of lochiae, retention of placenta. It can also be used during labour for difficult labour. Again, I would use the Yin Qiao Mai for these problems only in Full conditions and particularly from Blood stasis. Also, it is particularly indicated if the abdominal pain after childbirth is unilateral. When using the Yin Qiao Mai for these problems I would use its opening and coupled points (KI-6 and LU-7) together with KI-8 Jiaoxin, Ren-3 Zhongji, SP-6 Sanyinjiao and LIV-3 Taichong. 6. THE YIN QIAO MAI AND THE EXTERNAL GENITALIA The Yin Qiao Mai is not usually mentioned in connection with the external genitalia: in my experience it does affect this area and can be treated for such problems in men and women.
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