Osteopathic regulation of major body systems through Extraordinary Vessels Part 2: anatomical and physiological reading

Trying to find connections between Extraordinary Vessels and academic physiology is interesting but surely not simple[1]. Since these Extraordinary Vessels regulate the entire organism, we can successively mention for the brain: the « central autonomic network », which are the cerebral areas devoted to regulation of the autonomic nervous system, the default mode network, the hypothalamic-pituitary axis, or even other hypothalamic functions, such as the suprachiasmatic nuclei. For the spinal cord, the peripheral nervous system as well as the autonomic nervous system, we can also mention Wankura Kampik’s works[2] on segmental anatomy with its tripartition of the spinal nerve’s exit into three cutaneous areas in relation to the dorsal, the lateral and the ventral rami that evoke respectively the Governing Vessel, the Girdle Vessel, the Conception Vessel and the Penetrating Vessel both together for the last one.

To these concordances, we should add the relationships with the autonomous nervous system that regulates numerous physiological processes and seem to be one of the main anatomical substrates of the Extraordinary Vessels.

There are also connections with the circulatory system (Penetrating Vessel) and with the immune system (“defensive” energy called Wei in acupuncture terminology) and the Extraordinary Vessels.

Direct links with fascial system and adipose tissue are also described by some authors.

Thus, using Extraordinary Vessels, allows access to various regulatory and therapeutic levers.

[1] Correspondences with human anatomy are more obvious since each point can be correlated with one or more precise structures.

[2] Wankura Kampik, Ingrid. Segmental Anatomy, the Key to Mastering Acupuncture, Neural Therapy and Manual Therapy. s.l. : Elsevier, Urban and Fischer, 2010

Descriptive anatomy of the EOV and their relationships to different systems of the organism permits a better understanding of their organization.

All Extraordinary Vessels have an ascending path[1].

Each pair of meridians is formed by a central Vessel and a peripheral Vessel that complement each other (synergy of action).

[1] With the exception of the Belt Vessel which, as indicated by its name, that runs horizontally around the waist.

In practice, the 8 Extraordinary Vessels can be classified in two complementary families EOV1 (linked with the sympathetic system) and EOV2 (linked with the parasympathetic system).

The first family (EOV1) is formed by the following pairs:

        - Governing Vessel and Yang Motility Vessel (Du Mai-Yang and Yang Qiao Mai)

        - Conception Vessel and Yin Motility Vessel (Ren Mai and Yin Qiao Mai).

The 4 EV of the EOV1 family are linked to the sympathetic system and the endocrine system (hypothalamic-pituitary axis, pineal gland, thyroid, adrenals, ovaries and testicles).

Du Mai and Yang Qiao Mai couple.  

Origin and acceleration of the Yang

The musculoskeletal system

This coupling associates the Governing Vessel and its complementary EV, the Yang Motility Vessel, in relation to the locomotor system (spine, head and extremities), the posterolateral muscular chain and all the fascial exoskeleton that allow standing  and the body’s mobility.

These 2 EOV’s may be responsible for many musculoskeletal or neurological disorders, and some postural imbalances.

Their symptomatology is very similar but with manifestations that are more axial for the Governing Vessel and unilateral for the Yang Motility Vessel. For example, a median low back pain would be associated to a Governing Vessel dysfunction whereas a lumbo-sciatic pain would bring us to consider more the second EOV of this couple.

Ren Mai and Yin Qiao Mai couple

Origin and acceleration of the Yin

Extra-mesenteric visceral system and mostly hypophyseal controlled endocrine system.

This coupling associates the Conception Vessel and its complementary meridian, the Yin Motility Vessel, in relation to the endocrine system, the prevertebral plexus with visceral intent and the anteromedial myofascial chain.

In general, these 2 meridians are often involved with internal pathologies. We will more often encounter a Conception Vessel dysfunction in a young woman and a Yin Motility Vessel dysfunction in elderly people.

The second family (EOV2) is formed by the following pairs:

        - Penetrating Vessel and Yin Linking Vessel (Chong Mai et Yin Wei Mai)

        - Girdle Vessel and Yang Linking Vessel (Dai Mai et Yang Wei Mai).

The 4 meridians of the EOV2 family are predominantly linked to the parasympathetic system and the hormonal digestive system (pancreas and endocrine cells in the digestive system).

Chong Mai and Yin Wei Mai couple

Organization and preservation of the Yin

Vascular system and vagus nerve.

This pair associates the Penetrating Vessel and its complementary EV, the Yin Linking Vessel, in relation to the cardiovascular system and the vagus nerve linking the central nervous system and the enteric nervous system.

We find the deep central chain of the neck (visceral and vascular sheaths) and thorax (endothoracic fascia, pericardium and broncho-diaphragmatic membrane) connected to the diaphragm (phrenic center) and the psoas muscle.

In practice, all disorders with a vascular or emotional component depend on these 2 EOV’s.

Dai Mai and Yang Wei Mai couple

Organization and preservation of the Yang

Peripheral articular system and neuro-muscular system.

This pair formed by the Girdle Vessel and its complementary EV, the Yang Linking Vessel, is in relation to the articulations and the neuromuscular component of the locomotor system.

Here we have the crossing muscular chains connecting the pelvic and scapular girdles thus the upper and lower bodies, the front and the back, the right and the left of the body.

Many rheumatic diseases of the extremities or the girdles, as well as some dermatoses (especially those with itching) are caused by a dysfunction of this pair of EOV’s.

It is to be noted that all Extraordinary Vessels, with no exception, go through the thoracic diaphragm. Therefore, we should systematically integrate all the different pieces of the phrenic puzzle into the general osteopathic exam[1].

[1] Cf. chapter phrenic puzzle.

1. The posterior pillars of diaphragm: Governing Vessel

2. The vertical fibers of the diaphragm: Yang Motility Vessel

3. The xiphoid appendix: Conception Vessel

4. The costal digitations of false ribs (K8, K9 and K10): Yin Motility Vessel

5. The anterior pillars of diaphragm: Penetrating Vessel

6. The dome of the diaphragm and the K7 costal digitation: Yin Linking Vessel

7. The costal digitations of floating ribs (K11 and K12): Girdle Vessel

8. The vertical fibers of the diaphragm: Yang Linking Vessel

We may also highlight certain correspondences between the classical descriptions concerning the 8 Extraordinary Vessels and the 8 Osteopathic Mechanical Link units.

The fact that these 8 EOV’s “irrigate” all structures of the body shows the osteopath the interest of knowing well their anatomical path.

Testing Extraordinary Vessels is done through identification of the different osteopathic lesions along the pathway of these meridians by way of palpation and evaluation of the quality of the tissues[1].

[1] Cf. S. Paoletti, Le décodage fascial, Ed. Sully, 2021.

An opening point can be associated to each Extraordinary Vessel.

Opening points may also be called master points, crossing-meeting points or confluence points as they, too, belong to the regular meridians.

These master points can be used for diagnosis purposes as well as for osteopathic treatment for the different units if they present dysfunctions.

There are few comments on the palpation of the 8 opening points of the EOV’s, and it has recently been described in certain works[1].

In Osteopathic Mechanical Link[2], current research makes it possible to clarify certain modalities in practice and offer an osteopathic approach to the major systems of the body from these 8 opening points.

[1] G. Willem, Palpation subtile des points d’acupuncture. S.l. Editions Frison Roche, 2005.

[2] This means using the EV model for diagnosis (tension tests and inhibitory balance tests) and osteopathic treatment (recoil technique) of key points.

The 8 opening points, distributed from above to below and left to right.

7 LU (lung) and 6 KD (kidney)

5 TB (triple burner) and 41 GB (gall bladder)

6 PC (pericardium) and 4 SP (spleen)

3 SI (small intestine) and 62 BL (bladder)

The opening points present many features.

They all are distal points, located at the extremities of the upper and lower limbs.

Each point is in relation to a particular peripheral nerve[1].

All the points are double, bilateral and symmetrical, even when in relation to a central, single EOV.

With the notable exception of the 2 points on the heel (Yin and Yang heel Vessels), the master points are not located on the EOV’s pathways they command.

We describe 4 points for the upper extremity and 4 points for the lower extremity.

The 4 distal points of the upper limb (brachial plexus, C5-T1) mainly act, but not only, on the higher dysfunctions.

The 4 distal points of the lower limb (lumbosacral plexus, L1-S1) mainly act on, but not only, the lower dysfunctions.

It is often necessary to pair an upper opening point with a lower one to cover all the body’s dysfunctions (notion of coupled point).

In the first family of Extraordinary Vessels (EOV1), the pair of upper point/lower point is usually in a crossed relation. For example, the 3 SI point (vertebral axis) corresponds to the contralateral 62 BL point (peripheral axis)[2].

In the second family of Extraordinary Vessels (EOV2), the pair of upper point/lower point is usually on the same side. For example, the 4 SP point (vascular system) will correspond to the ipsilateral 6 PE point (parasympathetic system)[3].

It is possible to confirm the palpation of the opening points through fascial tension tests, applied to the upper and lower extremities according to protocols that will be published later.

[1] Extremities have a greater density of sensitive receptors and, for this reason, a larger cortical somatotopic representation. This partly explains their action on the central nervous system and the great functions of the body.

[2] Peripheral nerves carry motor, sensory and sympathetic fibers. The nervous pathways of the musculoskeletal system are crossed; the right motor cerebral cortex commands the left side of the body.  Likewise, for the optic nerve pathways: the left visual field is projected on the right occipital cortex. The opposite swings of the lower and upper extremities in walking demonstrates well this crossed relationship.

[3] The distribution of the right or left vagus nerve remains essentially ipsilateral, with different specific functional characteristics for the right and left vagus nerves.

Dr René Descartes, MD and acupuncturist (CHE)

Eric Prat, osteopath DO (FRA)

Translation: Chantal Fillon, osteopath (CAN)

Proofreading:  Ramy Raafat, osteopath (EGY)

Previous article

1st part: traditional concept of Extraordinary Vessels.

Articles to come

3rd 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.