Osteopathic regulation of major body systems through Extraordinary Vessels Part 4: clinical study Parasympathetic system

Following on from our previous article, let's recall that from an osteopathic point of view, each Extraordinary Vessel could be described with the following characteristics.

1. A master point used both for diagnosis (control point) and for treatment (command point).

2. A complementary point, paired to the previous one, in order to strengthen its action. 

3. A main pathway with secondary branches.

4. Key points to investigate, because they are susceptible to present osteopathic lesions along the EV’s pathway.

5. Warning signs, clinical symptoms most often encountered in case of dysfunction.

6. A specific morphotype, revealing à dominant EV[1], as far as we always find the same pair of points over time.

We present here an anatomical and clinical study of the Marvelous (Extraordinary) Vessels that regulate the parasympathetic system (MV2).

[1]We are aware that the concept of morphotype remains questionable and would require a real study. It serves here as an “educational caricature” to illustrate the dominance of an EV.  Observing a patient’s morphotype requires nuance and should not be considered an essential element of the diagnosis. A presentation of the psychological profile (temperament and character) attributed to each EV would be beneficial but this would go beyond the limited scope of this chapter.

PENETRATING VESSEL (Chong Mai)

OML : unit 5 (vascular).

Considered to be at the origin of all ordinary meridians, this EV irrigate the entire body with blood and energy.

In considering the Penetrating Vessel, we find here a fundamental concept of Still's:

“Seek the cause, remove the obstruction and let nature's remedy, the arterial blood, be the doctor.”

1. Opening point 4 SP: saphenous nerve, epiphyseal line of 1st metatarsal, insertion of tibialis anterior muscle.

Saphenous nerve and 4 SP opening point

Test for opening point 4 SP

2. Complementary point 6 PC.

3. Main pathway.

The Penetrating Vessel starts in the hypogastric area (genitals and perineum) and divides into:

- A para-median main branch running up the abdomen and thorax to the face;

- A secondary branch descending along the medial aspect of the lower limb.

There is also a deep ascending branch which irrigates the spinal canal and spinal cord (not shown).

Main pathway of the Penetrating Vessel and its descending branch

with its opening point 4 SP

4. Key points to investigate.

At the pelvic level:

Uterus, perineum, coccyx and filum terminale (for its relationship with the spinal cord), pubic symphisis[1] and abdominal pyramidal muscle.

At level of lower extremity:

Vessels of the lower limb with the femoral and saphenous nerves.

At abdominal level:

The entire vascular system, in particular the iliac bifurcation, the abdominal aorta and its branches[2], the inferior vena cava and portal venous system[3], the rectus abdominis muscles and the diaphragmatic crura (via the anterior approach).

At thoracic level:

The phrenic center, heart, large thoracic vessels (aortic arch, superior vena cava, pulmonary arteries and veins, azygos system).

At neck and head level:

The vascular sheath of the neck, including the vagus nerve and branches of the carotid artery (external and internal).

[1] With a high frequency of pubic symphysis diastasis in women (point 30 ST).

[2] Particularly if the affected opening point (4 SP) is on the left side.

[3] Particularly if the affected opening point (4 SP) is on the right side.

5. Warning signs.

- Circulatory pathologies: venous disorders of the lower limb, arteritis, vascular compression syndrome, etc.

- Cardiovascular disorders: precordialgia, infarct sequelae, heart failure, hypertension, congestive headaches.

- Neurovegetative dystonia, restless legs syndrome.

- Abdominal pain with distension, diarrhea, dyspepsia. 

- Irregular menstruation, hemorrhagic periods with blood clots, metrorrhagia, vomiting during pregnancy, sexual deficiencies, infertility.

6. Morphotype.

Man or woman, massive body, rather stocky, with a tendency to be overweight, wide neck, hand with short fingers.

Rather round face, with wide forehead and large mouth.

Sanguine temperament, jovial, optimistic.

YIN LINKING VESSEL (Yin Wei Mai)

OML : unit 5 (vascular and autonomic nervous system).

1. Opening point 6 PC: median nerve above wrist, tendons of hand flexors.

Median nerve and 6 PC opening point

Test of opening point 6 PC

2. Complementary point 4 SP.

3. Main pathway.

The medial line runs from the leg up to the groin crease, then along the lateral edge of the rectus abdominis to the thorax, ending at the anteromedian line of the larynx.

Main pathway for the Yin Linking Vessel and its opening point 6 PC 

4.Key points to investigate.

At lower extremity :

Saphenous nerve, femoral artery and vein, femoral nerve.

At trunk level:

Psoas muscle, phrenic center, pericardium, broncho-diaphragmatic membrane, arterial ligament.

At throat level:

Larynx, trachea, floor of mouth.

5. Warning signs.

- Psychosomatic conditions, emotional hypersensitivity, anxiety or depression.

- Oppressive manifestations of the thoracic area, lump in the throat, emotional dyspnea, precordialgia, heart palpitations, aerogastria, hiccups, nausea and gastric reflux.

- Lipothymia, vagal malaise.

6. Morphotype.

Slightly more often a woman, with no particular morphotype but rather angular features, a broad thorax and a marked sternal angle.

Emotional, anxious tendency.

Mrs. M. C. consults for various problems. As the left opening point 4 SP came out as primary, we asked her about her digestion. The patient has been suffering from recurrent diarrhea for over 20 years, with several loose stools each day. After treatment of this point, the diarrhea stopped the same evening, as if we'd pressed an on/off button. A year later, she returned with a recurrence of diarrhea. The same recoil treatment of the 4 SP point and associated osteopathic lesions will, with a 3-year follow-up, give a perfect and lasting result[1].

A 5-year-old girl, E. B., is brought in by her parents for a simple osteopathic check-up. She was in very good health, with no obvious complaint. The only clear fixation detected on examination was 6 PE point. When we asked the parents about any digestive problems, they mentioned a very debilitating motion sickness, as their daughter systematically vomited after driving in the car for around twenty minutes. All journeys are restricted, depriving the family of many outings. Treatment will focus solely on the normalization of the median nerve in the forearm (6 PC point). Following this “unicist osteopathic” consultation, the child has never again experienced nausea or vomiting in the car. The result has lasted for over 5 years.

Mr. S.V, aged 58, has been followed for several years for obesity, hypertension, hypercholesterolemia and type 2 diabetes. His cardiological work-up revealed the sequelae of a myocardial infarction and an abdominal aortic aneurysm. He suffers from severe stress and sleep apnea. He has been seen in acupuncture for over 4 years, with good control of the situation: the aneurysm is stable, and there has been no recurrence of coronary disease. In agreement with the cardiologist, the patient can lower the dosage of his medication. Points 4 SP and 6 PE are very often positive, but sometimes also 7 LU and 6 KD.

Mrs F. M., aged 35, consulted for neck pain and infertility which had remained unresolved for over 5 years. She had undergone a course of assisted reproduction, including 2 in vitro fertilizations (IVF) with embryo transfer, but without success. Desperate and very tired, she opted to take a break to “regain her strength” before possibly attempting another IVF. Tests direct us to right master point 4 SP, the right uterus and ovary[2], the right ovarian artery and the right diaphragmatic crus (path of the Penetrating Vessel). Treatment will be completed with the 6 PC on the same side. After 2 consultations, she is delighted to tell us that she is pregnant!

[1] As always in osteopathy, this is not a recipe. If your patient complains of diarrhea but the point in question has no fixation, there's no need to treat it!

[2] In accordance with current legislation governing osteopathic treatment in France, the MLO approach to the gynecological sphere is always performed externally.

GIRDLE VESSEL  (Dai Mai)

OML : units 1 and 2 (pelvic girdle), unit 5 (abdominal wall) and unit 6 (dermis).

1. Opening point41 GB: lateral dorsal cutaneous nerve of the foot, intermetatarsal joint between V and IV, tendon of extensor digitorum longus of the 5th toe.

Lateral dorsal cutaneous nerve of the foot and 41 GB point

Test for opening point 41 GB

2. Complementary point 5 TW.

3. Main pathway. 

The horizontal line around the lumbar area. 

Main pathway of the Girdle Vessel and its opening point 41 GB

4. Key points to investigate :

At abdominal level

Floating ribs and lower costal diaphragmatic digitations, thoracolumbar fascia, oblique and transverse abdominal muscles, ilio-hypogastric, ilio-inguinal and lateral thigh cutaneous nerves.

At pelvis level

Hip, sacroiliac joints and pubic symphysis, iliac muscle, inguinal ligament.

5. Warning signs.

- Acute rheumatoid arthritis, erratic pain, radiating low-back pain, hip pain, leg weakness, deformed rheumatic hands.

- Heavy legs, cellulitis, steatomeria (saddlebags).

- Skin disorders, vesicular dermatitis (shingles, eczema) or scaly dermatitis (psoriasis).

- Hormonal imbalances in women, menstrual headaches, premenstrual syndrome (pelvic congestion, breast pain).

6. Morphotype.

Structure often asymmetrical between top and bottom. Possible scoliosis.

More often a woman with a slim upper body and wide pelvis. Violin-shaped figure, saddlebags. Skin cellulitis without venous disorders.

Or a man with a broad thorax and narrow pelvis.

Hands appear deformed, with gnarled fingers.

YANG LINKING VESSEL (Yang Wei Mai)

OML : unit 2 (thoracic), unit 3 (peripheral) et unit 6 (nervous system and dermis)

1. Opening point 5 TW: posterior interosseous nerve of the forearm, adductor pollicis longus and extensor pollicis brevis muscles.

Posterior interosseous nerve of the forearm and 5 TW (TB) point

Test for opening point 5 TW

2. Complementary point : 41 GB

3. Main pathway. 

The vertical line that starts at the heel, runs laterally along the leg, follows the axillary line of the trunk, bypasses posteriorly around the shoulder, up the lateral face of the neck and head and ends behind at the craniocervical junction.

Main pathway of the Yang Linking Vessel and its opening point 5 TW

4. Key points to investigate.

At level of lower limb:

Fibular tendons, sural nerve, lateral cutaneous sural nerve, fibular nerve, fascia lata, dermis and fascias of the pelvic girdle.

At level of scapular girdle and neck:

Axillary, supra-scapular and supra-clavicular nerves, muscles and tendons of teres major, teres minor, deltoid, triceps brachii, elevator scapulae, trapezius.

At level of head and neck:

Splenius capitis muscle, sub-occipital muscles, greater and lesser occipital nerves, temporomandibular module, ear and epicranial aponeurosis.

5. Warning signs.

- Neuromuscular pain, tendinitis, torticollis, neuralgia, shoulder pain, trapezalgia, erratic or variable pain.

- Febrile conditions, various ENT infections, hay fever, sinusitis, dental problems, etc.

- Tension headaches influenced by weather changes or stress, retro-ocular pain, Arnold's neuralgia, facial neuralgia.

- Ear disorders, otitis, tinnitus, ear canal eczema.

- Certain skin disorders, skin allergies, dermatitis with pruritus, scars.

- Palpitations, functional precordialgia, thoracic tension.

- Anxiety, depression, with a feeling of thoracic tension.

- Gifted child, HIP (High Intellectual Potential).

6. Morphotype.

Slightly more often a man, normal morphotype, rather slim but with broad shoulders. The face is mobile and expressive.

Lively, nervous temperament.

Mr. N. B., a 32-year-old ambulance driver, has been complaining of very disabling shoulder pain for a year. A single session with points 5 TW and 41 GB, including two key points specific to the shoulder girdle, 10 SI (teres minor muscle and axillary nerve) and 15 TW levator scapulae muscle), will completely resolve his problem.

Mrs B. J., aged 75, consulted with severe right sciatica that has been present for over 4 months. The clinical picture was hardly reassuring: advanced ankylosing spondylitis, severe L5-S1 discarthrosis and right foraminal disc herniation. Tests led us to treat first the 5 TW opening point on the right side, then the cuboid of the right foot (beginning of the Yang linking Vessel path). Regulation of the complementary point 41 GB on the same side and a specific treatment of the herniated disc were then done[1]. The next morning, after considerable diarrhea during the night, the patient woke up without sciatica. When seen a month later, she reports, with a mixture of astonishment and satisfaction, that she no longer suffers at all.

M F.T., 32, a physical therapist, has been complaining for years of severe abdominal pain on his left side during exercise. As he specializes in the care of top-level athletes, he receives excellent medical treatment (x-ray, ultrasound, MRI, physiotherapy, osteopathy, postural and podiatric assessment, etc.), but the pain persists. He has a stressed temperament and is hypersensitive to electromagnetic waves, as well as being “allergic to the sun”. Several MLO sessions bring him some improvement, but do not prevent recurrences. During a consultation, we introduce the treatment of the Extraordinary Vessels with points 41 GB and 5 TW. When seen 6 months later, the patient told us he was pain-free and had resumed all his physical activities (tennis and surfing). He is also much less sensitive to electromagnetic waves and the sun. This surprising result can be explained by the strengthening of the Belt Vessel (the abdominal girdle) and the Yang Linking Vessel (sensitivity to external influences).

Mrs D. M., nurse, aged 43, has been suffering from severe rheumatoid arthritis and permanent fatigue for over 10 years. Fortunately, medical treatment and osteopathic follow-ups have brought her some relief.  At the umpteenth consultation, we introduced the 41 GB/5 TW pair for the first time, with regulation of the corresponding points. When seen 3 months later, the patient reported a very marked improvement of her pain and the disappearance of her fatigue. According to her, that session could in no way be compared previous ones. A particularly interesting example, given that we had not informed her we had changed the treatment protocol.

[1] See chapter on spinal segment lesion.

Eric Prat, osteopath DO (FRA)

Dr René Descartes, MD and acupuncturist (CHE)

Translation: Chantal Fillon, osteopath (CAN)

Illustrations:

Sarah Stringhetta from P. Chauffour, E. Prat E, LMO Evolutions et perspectives, Sully 2024

Benoit Caillé DO (FRA) from P. Chauffour, E. Prat, J. Michaud, LMO Points clés du système nerveux, Sully 2017

Previous articles

Part 1: traditional concept of Extraordinary Vessels.

Part 2: anatomical and physiological reading of Extraordinary Vessels.

Part 3: clinical study of the Extraordinary Vessels (sympathetic system).

Articles to come 

Part 5: osteopathic regulation protocol of the Extraordinary Vessels.