Osteopathic regulation of the body’s systems using the Extraordinary Vessels Part 1: traditional concept

In osteopathy, we pay a lot of attention to the 3 anatomical links between all the components of the human body: the fascial link, the vascular link and the neurological one. These 3 links have their own anatomical substrate but, in a global vision, it is the connective tissue, through its fascial network and its extracellular matrix that connects these 3 links[1].

In acupuncture, the concept of energy is essential and it could also, more or less, be in certain schools of osteopathy. But how can we understand, approach and evaluate the energy in a truly osteopathic way?

 “The wind blows, the leaf moves “. By not objectively paying attention to the structure (the leaf), I will not see, I will not grasp the energy (the wind). Then again, the structure is needed in order to “materialize” and perceive the energy. We can therefore concede that connective tissue, present throughout and filling everything, renders this invisible energy, which animates all living beings, palpable through its suppleness and its elasticity. With this in mind, we have, for many years, systematically integrated the tissular reality of the meridians and the acupuncture points in our osteopathic practice, in the same way as all other physical structures. Following on from our previous publications[2], the Extraordinary Vessels (EOV)[3] described in acupuncture and their master points[4]  have become nowadays a new source of inspiration.

After an Osteopathic Mechanical Link seminar, Dr René Descartes, co-writer for this paper, shared his personal findings on the Extraordinary Vessels (EOV) suggesting some reconciliation between the 8 EOV and the 8 units of Osteopathic Mechanical Link[5].

Would each of those EOV represent a particular functional or anatomical unit?

Is the EOV model really interesting to take into consideration for the osteopath?

If the master points can easily be tested, is it possible to determine which unit or units are of priority for treatment?  

We could also consider that stimulating master pts and/or others key points of the EOV may consolidate and amplify the treatment of a unit!?

It has been demonstrated in practice that the key points of the EOV are often found to present tissular fixations linked to the patient’s symptoms. Furthermore, treatment of these osteopathic lesions yielded surprising responses, even with complex, chronic or recurring, pathologies for which we had limited results.

Experience and clinical results have confirmed the pertinence of this approach. We are nowadays convinced that the EOV system fully deserves to be integrated as an extra diagnostic and treatment tool in osteopathy.

[1] Helene M. Langevin, David L. Churchill, Marilyn Cipolla, Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture, 2001

It is possible to define the osteopathic lesion as a scar that can affect all tissues of mesodermic origins: bones, joints, muscles, tendons, ligaments, fascias, aponeuroses, dermis, vascular sheaths, etc.

Even if the nervous system is derived from the ectoderm, we should keep in mind that more than 50% of the peripheral nerves are connective tissue originating from the mesoderm (epineurium, perineurium, endoneurium ) in addition to the connective sheaths (paraneurium) surrounding the nerves along their path.

[2] Chauffour P., Prat E., Michaud J.,  LMO Points clés du système nerveux périphérique, Editions Sully, 2017.

[3] Also known as extraordinary meridians.

[4] Appelés aussi points de commande ou points maître.

[5] Cf.  Diagnostic and treatment chapter using the Osteopathic Mechanical Link methodology.

Acupuncture holds a special place within alternative medicines. Like Ayurveda, it has a millennial history and is still primary care medicine in its country of origin. Models of understanding for its mechanisms of action exists and some are compatible with the dominant model within our faculties[1].

Cerebral functional MRI confirms the effectiveness of the needle-stings on certain points. Others studies guide us, to a detailed histology description of the acupuncture point[2] and even of the meridians’ anatomical reality linking the points.

Some osteopaths understood that there are close relationships between acupuncture and manual medicines and they thus integrated acupuncture in their clinical practice.

Actually, the acupuncture point is a very special zone of cutaneous covering giving access to the « interior of the body ».

The points are accessible, not only for needles but also through various types of stimulations: manual (digitopuncture or acupressure, tapping), electrical, light (laser), magnetic (magnets) or, this will be our choice, though a specific osteopathic adjustment such as the recoil.

Contact and stimulation of the point provide both diagnostic information and therapeutic possibilities for local and systemic actions. As a matter of fact, each point has its own specificities: some are « generalists », with multiple and systemic impacts, whereas others will generate a more local or regional impact.

Classically, the study of meridians starts with the 12 « main » meridians. Well known, even to the general public, they remain mysterious : first in regards to their anatomical reality and also their trajectories, that seem simple but are in fact complex, or their translations from the Chinese language and, unfortunately, associating them to organs.

Afterwards, the next level, the secondary or collateral meridians, classified in different families are studied: the musculotendinous meridians or some meridians that link the main meridians among themselves, called the « Luo », or the Extraordinary Vessels. Secondary does not mean of less importance, on the contrary.

Extraordinary Vessels seem to have an essential role during the embryonic period, creating some induction field for the development of the 3 embryonic layers and the tissues. It may be tempting to associate some Extraordinary Meridians with the 3 embryonic layers, but their role seems to be mainly functional at this time, by establishing successive induction fields for the development of the embryonic layers and the organogenesis. This may explain the morphotype of a person, it may reflect the energetic balance/imbalance among the activity of various EOV and it would be a good indicator of its constitutional weaknesses, to be taken into consideration as a priority.

The Extraordinary Vessels maintain a predominant role during adulthood. One of the EOV (The Penetrating Vessel) would be creating activity in all the Main meridians and, all together (the EOV), they would execute essential regulation functions on the Main ones. This would explain their unique role for treating chronic diseases, according to certain schools.

There are 8 Extraordinary Vessels, 4 EOV are central and the other 4 are peripheral EOV’s.

Using the traditional point of view, we can summarize their function as follows:

[1] Roux J-P., Du Bois R. Acupuncture générale, Éditions You Feng, Libraire et Editeurs, 2020.

[2] S.S. Ding, S.H. Hong, C. Wang, Y. Guo, Z.K. Wang and Y. Xu; Acupuncture modulates the neuro–endocrine–immune network. 2014, QJM, an International journal of medicine, pp. 341-345.

The 4 Central Extraordinary Vessels

    1. The Governing Vessel (Du Mai) controls all the Yang meridians for the body, the spine, the encephalon and the defense energy of the organism.

    2. The Conception Vessel (or Directing Vessel) (Ren Mai) guides all the body’s Yin meridians and the reproductive functions.

    3. The Penetrating (or Thrusting) Vessel (Chong Mai) is the origin of all the body’s meridians and regulates the blood distribution in the organism.

    4. The Girdling (or Belt) Vessel (Dai Mai) connects and maintains all the body’s other meridians with a vertical trajectory.

The 4 Peripheral Extraordinary Vessels

   1. The Yang Heel Vessel (or Yang Motility vessel) (Yang Qiao Mai) commands all voluntary movements, the body’s motricity, the eyes mobility and the paradoxical sleep.

   2. The Yin Heel Vessel (or Yin Motility vessel) (Yin Qiao Mai) manages involuntary movements, organ motility, liquid fluctuation, closure of the eyes and slow-wave sleep.

   3. The Yin Linking Vessel (Yin Wei Mai) regulates our emotional system, the heart and certain types of generalized osteo-articular pains (fibromyalgia syndrome).

   4. The Yang Linking Vessel (Yang Wei Mai) preserves the memory of the past, acquired automatisms and manages, in part, our adaptation capacity to external influences (climatic changes, pathogenic factors, allergens, etc.).

Only 2 of the EOV have their own points: the Governing Vessel and the Conception Vessel. The other 6 share points with the Main meridians.

We have to address the basics of acupuncture in order to explain their functions, especially the Yin and Yang or the coupling notions of the innards called « Fu » of Yang nature, and the organs called « Zang » of Yin nature.

In acupuncture, the innards are the « hollow organs », such as the bladder, the stomach or the large intestine, by opposition to the « solid organs » like the kidney, the liver and the spleen. They do not possess certain characteristics found for the coupled main meridians such as the notion of inwardness and outwardness. They are though classified according to their Yin or Yang and various couplings amongst them are suggested.

Their existence has already been mentioned in the founding texts, for example the « Ling Shu »[1], a few centuries prior to our era. They are, initially, considered as custodians of our constitution, and in relation to a partially fixed destiny.

In considering the Main meridians as rivers, « energy currents », the Extraordinary Vessels would be lakes or reservoirs with regulatory functions: substitute the energy in case of deficiency or absorb it in case of excess of the main meridians.

It is to be noted that ancient texts, even if they mention the Extraordinary Vessels, do not address them therapeutically speaking. A precise description of the 8 master points was only given in the 15th century and then, only a century later, was there a real treating with propositions for treatment in acupuncture as well as with plants through the Chinese pharmacopeia.[2]

In recent years, Giovanni Maciocia’s works and certain Japanese authors have furthered the study of the EOV ’s role by synthesizing and simplifying the traditional notions with new clinical conceptions.

The philosophical conception of the Yin and the Yang is specific to the ancient Chinese thinking, in particular the Taoism. The Yin and the Yang are interdependent and highlight inseparable opposites: day and night, activity and inactivity, slowness and speed, beginning and end, cold and warmth. But they are also relative concepts: running the marathon is Yang in nature in opposition to remaining seated on the couch. The pause during which the marathon runner takes a break to refuel is Yin in regards to the run itself that is Yang, etc.

If we summarize the functions of the 8 Extraordinary Vessels by using the acupuncture’s specific terminology, we can say that there are 4 vessels that are of Yang nature and the other 4 are of Yin nature.

There are 4 great functions for each vessel of the 2 groups (Yin and Yang): first of all, being the origin of, then accelerate, next preserve and finally organize.

[1] Wong, Ming. Ling-Shu. s.l. : Masson , 1987

[2] Chace Charles, Miki Shima. An exposition on the Eight Extraordinary Vessels de Li Shi-Zen. s.l.: Eastland Press, 2010.

Thus, for the Yin, we have the Conception Vessel (origin), the Yin Heel Vessel (accelerator), the Yin Linking Vessel (preserver) and the Penetrating Vessel (organizer) for the Yin.

Likewise for the Yang, there are the Governing Vessel (origin), the Yang Heel Vessel (accelerator), the Yang Linking Vessel (preserver) and the Girdling Vessel (organizer).

Dr René Descartes, médecin-interniste et acupuncteur

Eric Prat, ostéopathe DO

English translation: Chantal Fillon, osteopath DO

Proofreading: Ramy Raafat, osteopath DO

Articles to come: 

2nd part: Physiological reading of the Extraordinary Vessels.

3ed part: Clinical study of the Extraordinary Vessels (sympathetic system).

4th part: Clinical study of the Extraordinary Vessels (parasympathetic system).

5th part: Osteopathic regulation protocol of the Extraordinary Vessels.

References:

https://ymaa.com/articles/the-eight-extraordinary-qi-vessels-part-1

https://yinyanghouse.com/theory/acupuncturepoints/theory_ev/#details

https://acupuncturetoday.com/article/30252-the-eight-extraordinary-meridians-our-genetic-imprinting

https://acuproacademy.com/the-8-extraordinary-vessels-made-easy/