Lecture 4: Chong Mai Flashcards
Below the umbilicus and in between the kidneys is the _______ ___ (or Motive Force, ____ ___) which is the source of human life and the root of the _____ ________. The _____ of _______ is the Penetrating Vessel which is also the _____ of _____ Yin and _____ Yang Organs. - Who said it?
Moving Qi (Dong Qi) 12 Channels Sea Blood Sea Five Six - Yang Shang Shan
Chong Mai is also called the _____ of the ____ ________. It oozes into the ______ and irrigates ________ and it therefore reaches all the Yin and Yang organs. The Moving Qi below the umbilicus is in the ________. The Penetrating Vessel starts in the _______ and is the Sea of the Channels. It moves up and down and in its _________ movement it connects with the _______ ___________ channel of the Kidneys. Therefore this _________ movement of the Kidney Qi is ____ the kidney channel. What dynasty?
Sea 12 Channels Yang; Essence Uterus Uterus downward; Great Connecting downward; NOT Sui Dynasty (581-618)
The “chong” may be translated as ________ or ____ but can also mean ______ or ______. Some other words connected to Chong are: Jie? Dong? Xing? Tong?
thoroughfare; hub; flush; surge Jie - streets Dong - activity, movement Xing - movement Tong - free passage
What is the Opening/Master/ Confluent point of the Chong Mai? What are the other hats of this point? Location and needling?
SP4 Gongsun (Grandfather Grandson) Luo connecting point of the Spleen channel Located on the medial side of the foot, in the depression distal and inferior to the base of the first metatarsal bone. Perpendicular insertion 0.5-1 cun
What is the Coupled point of Chong Mai? What are its other hats? Location and needling?
P6 Neiguan (Inner Pass) Master point Yin Wei Mai; Luo connecting point of the PC channel Located on the flexor aspect of the forearm, 2 cun proximal to P7; wrist joint, between the tendons of palmaris longs and flexor carpi radialis Perpendicular insertion 0.5-1 cun
What points does Chong Mai include?`
CV1, S30, K11-21
What areas of the body are influenced by Chong Mai?
Big toes, feet, medial aspect of legs, uterus, lumbar spine, abdomen, chest, heart, breasts, throat, face, head
Channels influenced?
SP, S, LV, K, HT, SI, LI
Name the branches of the Chong Mai trajectory?
1) Internal 2) Abdominal 3) Head 4) Spinal 5) Descending
Internal Branch
Originates inside the abdomen, flows through the uterus and emerges in the perineum at CV1
Abdominal Branch
Emerges at S30, connects with the kidney channel at K11 and ascends through the kidney channel to K21 and then disperses in the chest and breasts
Head branch
Flows over the throat, around the chin, curves around the lips and terminates below the eyes
Spinal branch
Emerges from CV1 and ascends inside the lumbar spine
Descending branch
Emerges from S30 and descends along the inner aspect of the thigh and lower leg to the medial malleolus. At the heel it separates, one branch going to the foot’s arch to connect with the Kidney channel and another branch going to the big toe to connect with the liver channel.
What is responsible for facial hair? What happens after menopause?
Blood going to the head branch of Chong! Head branch has more blood after menopause meaning more facial hair.
The internal branch is functionally related to what?
Kidney and uterus
Clinical significance of internal branch?
Flows through the uterus therefore menstrual flow and disorders.
Clinical significance of the abdominal branch?
Pathology of Rebellious Qi of the Chong Mai and association with Membranes (Huang)
Clinical significance of the head branch?
Lump in the throat, facial hair
Clinical significance of the spinal branch?
Menstrual pain in lower back
Clinical significance of descending branch?
Restless leg syndrome, three Yin of the leg, Yin and Qi to the feet, move Qi in the uterus, fungal infections of the big toe
Point combination for restless leg syndrome? Is it necessary to use the master/couple points?
K11, S30, S37, S39, SP6 No
Point combination for problems of circulation in the feet with coldness, numbness, tingling, purple colour?
SP4, P6, K11, K13, SP6, K4
Sea of Blood: Clinical Significance? The Sea of Blood relates to the fact that the Chong Mai controls the _______ of Blood in the _______ as well as the ______ ______ _________ channels. This would mean that the Chong Mai affects many _______ _____________ that are extremely common in ____________ diseases.
movement; uterus; Deep Blood Connecting Blood pathologies; gynaecological
We can also see a correlations via the _____ _________ (___) channels that the Chong Mai can be used to treat ______ _____ not only in the __________ system but anywhere in the body.
Blood Connecting (Luo); Blood Stasis; gynaecological
Further many of the clinical symptoms attributed to the Chong Mai are the result of ___________ of _________ of blood and particularly vulnerable to ______ _______.
obstruction; movement; blood stasis
What are general symptoms of blood stasis?
- Pain and distention of abdomen - Pain in the chest - Pain and distention under the ribs - Various abdominal masses - Pain and swelling of the testicles - Localized blood stasis masses occurring anywhere in the body
Sea of the 12 Channels: Clinical Significance? The Chong Mai is also called the Sea of the 12 Channels. Since it is both the Sea of Blood and the Sea of the 12 Channels it influences the ___________ of ___ and ______ in the ______ body.
movement; qi; blood, whole
Sea of the 12 Channels controls?
- Controls all connecting channels - Controls all channels of the abdomen - Controls circulation of Qi and Blood in all channels (except in the arms)
A discussion by Pirog, The Practical Application of Meridian Style Acupuncture, suggests that the Chong Mai may be seen as a ______ ________ to map __________ _________ and would help explain why the ______ ____ calls this vessel the “Sea of Blood.”
primitive attempt; arterial circulation; Ling Shu
Further that the title “the sea of twelve channels” alludes to the Chong Mai’s role in _______ __________ and that the Chong Mai is the only vessel which _________ throughout its ______ _______.
general circulation; pulsates; entire course
Where are the pulses felt throughout the body?
- Dorsalis Pedis - Posterior Tibial - Anterior Tibial - Femoral - Aorta - Common Carotid
The Chong Mai is the Sea of the Five Yin and Six Yang Organs because it is the extraordinary vessel at the ______ of the _________ _______ created by them. What is the evidence of this?
center; energetic vortex - It is the link between the Pre-Heaven Qi (Kidneys) and Post-Heaven Qi (Stomach). - Due to its pathway it is directly influenced by many organs and is related to the Three Treasures (San Bao). (review diagram)
Rebellious Qi of the Chong Mai produces various symptoms at different levels of the abdomen and chest. Name as many of these as possible!
- Cold feet - Fullness/distension/pain of the lower abdomen - Hypogastric fullness/distension/pain - Painful and/or irregular periods - Fullness/distention/pain of the umbilicus - Fullness/distention/pain of the epigastrium - Feeling tightness below the xyphoid process - Feeling of tightness of the chest - Palpitations - Feeling of distention of breasts - Slight breathlessness - Sighing - Feeling of lumps in the throat - Feeling of heat in the face - Headache - Anxiety, mental restlessness, internal urgency
What is internal urgency?
Internal urgency may indicate pain, constipation, retention of urine, hernia, anxiety, dizziness and nausea, especially in an illness that has an emotional background
Do all of the symptoms of Rebellious Qi of the Chong Mai need to occur simultaneously in order to diagnose it?
No. It is necessary to have at least three to four symptoms at different levels e.g. lower abdomen, epigastrium, chest, throat…
What is a typical symptom of Rebellious Qi of Chong?
Hot face, cold feet. Qi rebelling upward but deficiency in the descending branch. Make note the flushing of the face is not always Yin Xu or Excess Heat!
What causes the qi of the Chong Mai to rebel upwards? (Patterns)
There are two main patterns that Maciocia discusses. 1) Primary rebellious Qi of the Chong Mai (Full Pattern) 2) Secondary rebellious Qi of the Chong Mai (Mixed Full/Empty pattern)
What is the cause of the full pattern of rebellious qi?
In this pattern we see Qi rebelling upwards by itself as a result of emotional stress making Qi rise or stagnate: anger, repressed anger, worry, frustration, resentment, etc.
What points would we use for the full pattern of rebellious qi?
SP4/ PC6 LI4/LV3 K14 bilaterally (good for stuck qi) K21 bilaterally (end pt. of Chong Mai, useful in calming)
What are the two causes of the mixed full/empty pattern?
This pattern is a consequence of a Deficiency in this vessel in the lower abdomen. 1) Qi of the Lower Dan Tian is weak and the Qi of the Chong Mai escapes upward. 2) The Empty condition is deficiency of Blood and/or deficiency of the kidneys (Yin or Yang)
When is the secondary mixed full/empty pattern most likely seen?
In symptoms relating to menopause.
What points would you choose for the mixed full/empty pattern of rebellious qi?
SP4/PC6 LI4/LV3 K13 bilaterally - for menstrual irregularities K21 bilaterally RN4 - tonifies K qi
Blood stasis in gynecology: What are three Blood pathologies that are at the root of many gynecological problems?
1) Blood deficiency - seen with amenorrhea or scanty periods 2) Blood heat - seen when periods are very heavy 3) Blood stasis - seen with painful periods and when menstrual blood is darker with clots
With what blood pathology is the Chong Mai particularly good for? What points would you use?
Particularly to invigorate Blood when there is Blood stasis in the Uterus SP4, P6, K14, SP10
Chong Mai and the Female Breast: The Chong Mai disperses in the ______ and ______ and therefore its Qi has a deep influence on the ________.
chest; breasts; breasts
The connective tissue in the breasts is part of the ___________ (_________) and Qi stagnation in the Chong Mai will affect the _________ and thus the breasts.
Membranes; Huang; Membranes
What doe we know about TCM and breast milk?
Breast milk is a direct transformation of menstrual blood into milk.
The Chong Mai arises from the ______ (which stores menstrual blood) and being the Sea of Blood it controls the _______ _________ channels. It is therefore responsible for the production of ______ _____ after childbirth.
Uterus; Blood; Connecting; breast milk
What is agalactia?
absence of breast milk
If the Qi of the Chong Mai _________ after childbirth or if the _______ of the Chong Mai is ____________ agalactia may arise.
stagnates; Blood; deficient
What are the sn/sx for Stagnate Qi of the Chong Mai Full condition? (Stagnant Qi after childbirth)
The breast milk is there but it is difficult to express because of the Qi stagnation.
What are the sn/sx for Deficient Blood of the Chong Mai Empty Condition? (Deficient Blood after childbirth)
The breast milk may be lacking because there is not enough Blood to be transformed into milk.
What is the point prescription for agalactia?
SP4, P6, SI1, RN17 (if painful breasts, needle toward breasts)
Chong Mai and the Heart: There are differing ideas in regards to the Chong Mai and its association with the Heart. Maciocia states that the Heart is related to the Chong Mai because….
it disperses in the chest and that is the Sea of Blood.
Maciocia states that the Chong Mai may be chosen in treatment of ___________ and _______ during menopause as these symptoms are caused by …
palpitations; anxiety; the decline of the Blood of the Chong Mai with consequent rebellious Qi escaping upwards.
Maciocia also mentions that the Chong Mai according to ancient texts may be used to treat the ______ kinds of _____ _____ and that the Chong Mai influences…
nine; heart pain … the heart rhythm and can be used for arrhythmia
What are the nine kinds of heart pain?
Article by Nicholas Sieben. Do not need to know them but understand about them.The Heart Channel and its partner the Pericardium Channel are associated with a concept known as “The 9 Palaces.” A palace is a type of life-lesson to be reckoned with throughout life. Chinese philosophy names 9 main life-lessons: Health, Wealth, Prosperity, Relationship, Children/Creativity, Travel/Adventure, Career/Vocation, Wisdom and Family. Through working through these palaces, wisdom and enlightened evolution is achieved. When a person becomes stuck in a palace, unable to come to terms with its lessons, it becomes a “Heart Pain.” The 9 Heart Pains can manifest physically, mentally or emotionally. Their origin is from a spiritual struggle to transcend one of the 9 Palaces.”
What is the main vessel indicated in patterns involving the heart? What do rules of extraordinary vessel therapy dictate?
Yin Wei Mai That its coupled pair, Chong Mai, must share this role of being connected to the heart.
What can the Chong Mai be invoked to help with?
- Can be invoked to quiet disturbances of the spirit, particularly those which are associated with blood vacuity or spleen dysfunction, with such signs as abdominal or digestive symptoms, dysmenorrhea and spleen-type emotions such as obsession and worry.
What function of the Chong Mai is there debate about?
Debate as to whether the Chong Mai’s connection to the Uterus plays a role with the Heart Qi/Heart Blood promotion of the discharge of menstrual blood and the discharge of the eggs during ovulation.
Chong Mai and the Stomach: Chong Mai emerges from the point _____ QiChong, which is the upper point of the ____ of _____. Therefore the Chong Mai is closely connected to the Stomach via this point, as the ____ of _____ is functionally related to this vessel.
S30; Sea of Food; Sea of Food
The Chong Mai vessel can be used for any _______ _________ but particularly those of a ____ nature such as: (name four)
stomach disorder; full 1) Cold Invading the Stomach 2) Stomach Qi not Descending 3) Blood Stasis in the Stomach 4) Stomach Heat
What are some points that can be used for Stomach disorders of a full nature?
SP4, P6, KI21, ST19 (last two are level with RN14 which is Front Mu point of the Heart)
Chong Mai and the Male Genitals: The meaning of the term _____ ____ literally means _________ ________.
Zong Jin; Ancestral Muscle
What are the two principal groups of interpretation for Ancestral Muscle?
- refers to the rectus abdominus muscles - refers to the penis
The rectus abdominus muscles run vertically through the abdomen on either side of the midline. They are attached to the _________ process and ________ ____ above and to they __________ ______.
xyphoid; lower ribs; symphysis pubis
The Chong Mai runs along all the ______ points which are ____ cun from the midline. These points lie on the ______ border of the ________ __________.
kidney; 0.5; medial; rectus abdominus
The Stomach channel points are ___ cun from the midline - lies on the muscle itself but toward its ________ border.
2; lateral
The points ____ and ____ are right over the _________ of the rectus abdominus.
K11; S30; insertion
If the Chong Mai is not flourishing the ___________ muscles are ______.
ancestral; slack
A slackness of the ancestral muscles may cause ___________ of the __________ in women and some types of __________ of the legs.
prolapses; uterus; atrophy
The insertion of the rectus abdominus at the pubic bone is just above the ____ of the _____. The Chong Mai being the Sea of Blood and influencing the Zong Jin plays a role in ___________ and therefore _________ ___________.
root; penis; erection; Erectile Dysfunction
Recall the point prescription from the Du Mai regarding erectile dysfunction. What kind of a pattern is this?
SI3 on the left, UB62 on the right RN4 UB23 bilaterally Kidney Yang Xu Pattern
What points would you choose for a Kidney Qi Xu pattern of erectile dysfunction?
SP4 on the left, P6 on the right K13 bilaterally K11 bilaterally RN4
What points would you choose for a Heart and Kidney Xu pattern of erectile dysfunction?
SP4 on the left, P6 on the right K12 bilaterally RN4 and RN6 UB15 and UB23 for tonification
What are the causes of prostatic hypertrophy?
Prostatic hypertrophy is usually due to a combination of pathogenic factors among which are Phlegm, Blood Stasis and Dampness.
Discuss the underlying causes of the pathogenic factors associated with prostatic hypertrophy.
- Blood stasis in the prostate is always a pathology of the Chong Mai - Phlegm and Dampness occur because of a stagnation in the Connecting channels of the prostate. - There is usually a Kidney deficiency (Yang or Yin) underlying the pathogenic factors.
How would you treat prostatic hypertrophy? What points?
Treat prostatic hypertrophy by tonifying the Kidneys, resolving Phlegm and Dampness and invigorating Blood: SP4, P6, RN4, S28, K14, LV3
What points does Chong Mai include?
RN1, ST30, KI11-21 (go study with Points PC)
