This has been a bone of contention among researchers for some time. Anatomical studies have not revealed any unique or distinct structures to the meridians although there have been some claims to the contrary.11 The most revealing area of research has come from doctors Darras and DeVernejoul in France11. They injected a radioactive tracer dye (Technitium99) into and acupuncture point and then into a nearby blood vessel and then into a nearby lymph duct to see where the dye went and what the differences might be. It turned out that each was distinctly different and the dye injected into the acupuncture point traced out the traditional path of the meridian that point was on! You can “see” the meridians on the Gamma camera pictures or CT scan (add photo)!
Two conclusions can be drawn from this: the meridians take advantage of existing biological structures and are associated with the circulation of extracellular fluid. These are significant findings in several ways. Most importantly, extracellular fluid is the medium of exchange of nutrients and waste products between inside the individual cells and outside the cells. This circulation must be effective for the cells to function properly. In Western medicine, it is thought that this circulation is mediated solely by the lymphatic system. Drs. Darras and DeVernejoul’s research proves that there is a second system that assists the lymphatic system in its work. Since the lymphatic system’s fluids are circulated mainly by the mechanical pumping action of physical activity, the acupuncture meridians can best be thought of as assisting in the circulation of extracellular fluid especially during periods of rest and inactivity. Interestingly enough this correlates with the TCM concept that the Qi of the meridians moisten and nourish the tissues of the body! So, think of the acupuncture meridians as consisting of the spaces between the cells (only ~5 microns by 15 microns in size) organized into channels or pathways. They also take advantage of “seams” between muscle groupings as a careful review of where the meridians are suggests14.
There are other aspects of their research which are equally revealing. For one, the dye always migrates from the periphery towards the center of the body. I asked them about this at a symposium I attended in the mid 80’s and they said that the dye was an “external pathogen” and according to TCM, “external pathogens” always travel from the peripheral to the center of the body (the heart). Well if the meridians are associated with the circulation of extracellular fluid, then indeed that flow will eventually return to the heart where it mixes again with the blood to continue its journey throughout the body. It doesn’t have anything to do with being an “external pathogen” but more to do with how extracellular fluid circulates. But to be fair, the lymphatic system does have a significant role to play in the workings of our immune system. And external pathogens can travel deeper into the body through this circulation system.
Another TCM concept associated with Qi circulation in the meridians is the direction of Qi flow in the individual meridians. For example, the Stomach channel is said to normally flow from the stomach down to the foot. When you have nausea or vomiting, it is said that you probably have “rebellious Stomach Qi” or Qi flowing in the wrong direction. So, it is understandable that that for channels like the Stomach or Lung (ex. Coughing) the normal flow of Qi could mistakenly be thought of as flowing from center to periphery based on those conditions. In addition, there is the TCM thought of the circulation of Qi through all the meridians in a 24-hour cycle with periods of energetic maximum and minimum. This has been established by careful observation and should be more correctly thought of as related to the diurnal (day-night) cycle of the autonomic nervous system and not of the Qi flow in the meridians. It should more properly be thought of as the strength of the flow and not its direction. Here we have a TCM concept that is largely correct but misinterpreted. This diurnal cycle does exist and can be measured as an ebb and flow of conductivity of key acupuncture points over the course of the day.
Another phenomenon observed with this technique was the occasional “jump” of the dye from one channel to an adjacent channel. This correlates with the idea in TCM of a “blockage” in the channel interfering with normal Qi flow. In TCM it is thought that stagnant or blocked Qi can cause pain. This pain usually manifests as an achy pain in clinical practice. With our new understanding of the nature of the acupuncture meridians (channels or pathways), this makes perfect sense. Interfering with the circulation of extracellular fluid will cause a buildup of the waste products of metabolism inside the cells and a lack of new nutrients for the affected cells. Much like overusing muscles causes a buildup of lactic acid inside the cells and makes your muscles ache, stagnant or blocked channels can also cause an achy pain.
Yet another interesting phenomenon observed by doctors Darras and DeVernejoul was the change in the rate of dye migration when the associated organ suffered from an inflammatory or degenerative condition. It was observed that if the associated organ was suffering from an inflammatory condition, the rate of dye migration was faster than normal. Alternatively, when the associated organ was suffering from a degenerative condition, the rate of dye migration slowed down or stopped completely. They also observed that needling or laser stimulation of another point on the same channel also affected the rate of migration in both the channel that was needled and the same channel on the opposite side of the body to a somewhat lesser extent. In TCM it is widely recognized that needling one side of the body can affect both sides of the body. So here we have an observed phenomenon that may explain in part how treating one side can affect both sides.
But what causes the change in dye migration or even the migration itself? It certainly isn’t residual pressure from the vascular bed since then the rate of migration in the acupuncture meridians and the lymphatic ducts should be about the same and they’re not. There is one possible mechanism that most people, even MD’s aren’t familiar with. It’s called electro-osmosis. It was discovered by the renowned Swedish Radiologist Bjorn Nordenstrom15. It reveals that an electric field in a tissue matrix (not in a bucket of water) will cause water to migrate to the negative pole of the field. He also ascertained that inflammatory conditions have an accumulation of negative charge (and Robert Becker showed that regenerative processes are also electro-negative16) compared to surrounding tissues and degenerative conditions are electro-positive compared to surrounding tissues. This correlates very well with change in migration rate with inflammatory and degenerative conditions.
In addition, sticking a needle through the skin causes free electrons on the surface of the skin to be conducted through the needle (and even through the break in the skin after the needle is removed) and cause an accumulation of negative charge under the skin. (Insert picture) This accumulation of negative charge can then influence the flow of extracellular fluid in the acupuncture meridians when the needle is placed along the channel. When placed more proximally, it would tend to increase the flow rate, and when placed more distally, it would tend to reduce the flow rate. This is precisely what the French research showed: if you needled proximal to the injection site the observed flow rate increased and if you needled distal to the injection site you decreased the flow rate. It is interesting to note here that generally speaking, in TCM needling points on the trunk are said to be more tonifying, and needling on the arms and legs (and especially the most distal points on the arms and legs) are said to be more sedating. All of this strongly suggests that electro-osmosis is likely playing an important role as one of the mechanisms of acupuncture.
It also suggests new treatment approaches for the treatment of diabetic and drug induced peripheral neuropathy and neuralgias (especially in the lower legs/feet), and as an aid in the treatment of gout and edema (and my own clinical experience has born this out.). In most of these cases an accumulation of toxins in the tissues is suspected and logic tells us that stimulating the return flow of extracellular fluid should help the problem. For example, I have treated several patients with these types of problems in the feet and lower legs and there was clearly no problem with the blood circulation. By needling points around the knees on the channels affected by the problem, significant improvement of their condition was observed thus further validating this theoretical construct. One patient had seen another acupuncturist 9 times with no effect on her problem. But with using this new approach, we saw noticeable improvement even after just the first treatment!
There is one more issue associated with what the channels are that should be addressed now. And that is the existence of channels between the traditional channels found in TCM. These are well known and accepted in German electro-diagnostic techniques such as EAV, BFD, and Vega Testing. They even give them names. In my own practice, I have observed several patients whose conditions strongly suggested their existence. Two of them had massive leg trauma with shattered bones and some tissue torn out. That massive trauma, and even the surgery to repair it left the tissues with significant disruption of the circulation of extracellular fluid. There was pain along the areas in between the Stomach and Gall Bladder channels and between the Gall Bladder Channel and the Urinary Bladder Channel that was not responding to treatment just along the traditional channels. Palpation revealed local ahshi points that “felt” just like typical acupuncture points and which also fell into the typical grid-like pattern found with acupuncture points throughout the body. Electro stim along all the channels (both traditional and non-traditional) gradually opened the circulation (I’ll explain how later) and relieved the chronic pain these patients were suffering from. I have occasionally observed a similar situation with lateral epicondylitis. One patient in particular, had pain not at points along the San Jiao and Large Intestine channels (typical) but along a pathway between the two. There was a local ahshi between SJ9 and LI10 and distally lateral to and a bit more distally than SJ5. Treating them like any other local-distal point combination worked just like the more traditional points usually do. It would be very interesting to see the French research applied to these channels as well.