Network Vessels: 絡脈 Luo Mai

The Luo (絡) are vessels containing Blood. The character refers to a net that enmeshes and enwraps implying both the physical appearance of blood vessels and to their function of connecting the Spirit and Soul to the body. Ling Shu ch. 8 says "the Blood houses the Soul (魂 Hun) ... the Vessels (脈 Mai) house the Spirit (神 Shen)" so the network of blood vessels that supply the body with Blood also allow the Spirit and Soul of the person to permeate every part of their body. These are probably the oldest form of acupuncture, described in the earliest literature of Chinese medicine, the Mawandui manuscripts, which describe the Mai and bloodletting but not needling at specific points to manipulate Qi (Ramey & Buell, 2010). The Nei Jing is also largely concerned with bloodletting, forming the majority of therapeutic needling described in the earlier portions of the text. It is even possible that this form of therapy extends back to shamanic practices of ritual blood sacrifice in the Shang dynasty where the spilling of blood was an important symbolic act in ritual sacrifice (Campbell, 2018; Micunovic, 2018). The reverence for the power of blood continued in the practices of blood writing and self-harm well during the Ming and Qing dynasties (Yu, 2012) and so almost certainly permeated medical practice too.

Su Wen, ch. 63, describes how pathogens penetrating from the Exterior can become stuck in the Channel and Network system before reaching the Zangfu.

This states that one important function of the Luo is to divert and restrain Pathogens, preventing them from reaching the Zang Officials. After passing the skin they can be contained by the "Granchild Luo 孫絡" which implies the smaller capillary network that infuses the Sinews. If this cannot contain the disease it progresses to the main Luo:

"Strange Diseases (奇病 Qi Bing)" suggests something unusual or extraordinary. It goes on to describe them as:

This suggests that "Strange Diseases" lack consistent symptoms but move around erratically and might be considered in modern terms as psychosomatic, supporting the quote from the Ling Shu ch. 8 that connects the Blood and Vessels to the Soul (魂 Hun) and Spirit (神 Shen)." In contrast, the "Grandchild Luo" feed the Sinews and their obstruction does not cause Strange Diseases but rather the fixed pain conventionally associated with Blood Stasis and the Sinews.

Ling Shu ch. 10 declares that, while the Primary Channels are usually invisible and must be diagnosed by palpation, the Luo can be seen externally. Furthermore, the nature of the Pathogen can be determined by the colour of the vessels: green-blue for Cold, red for Heat, black for long-term Stasis. The combination of visible changes in Blood circulation, the close association of the Shen and Hun with the Blood and vessels and the suggestion that their pathology brings about "Strange Diseases," all point to the Luo being a map of changes in circulation, which modern research by Lauri Nummenmaa confirms has a close relationship to emotional states (Nummenmaa et al., 2014; Nummenmaa & Saarimäki, 2019; Nummenmaa, 2022). It is worth noting that in these maps, happiness seems to highlight the whole body, matching the description in the Su Wen ch. 39, that says elation causes the Qi to relax, opening all the Luo simultaneously.

The last four also have an additional pathology of "Rebellion" in their Ling Shu symptamology. These are the Stomach and the others are the three Leg Yin channels. These appear to be in relation to Qi and Blood moving contrary to the normal movement in that channel but no explanation for there being rebellion in these four only is given.

Sequence

The exact sequences present something of a mystery, almost fitting a pattern but never completely.

The only certain pattern is that it describes all the Hand Yin, followed by Hand Yang, Foot Yang and then Foot Yin, apparently enclosing Yang within Yin. Within each group, the sequence has several close patterns. Each trio moves from Tai "Greater" to Shao "Lesser" to Jueyin or Yangming, or in the language of the Su Wen ch. 6, they Open, Pivot then Close, with the exception of the Hand Yang Luo that break this pattern, going Taiyang, Yangming, Shaoyang. Another sequence is that the Hand Yin and Foot Yang channels are opposite Earthly Branches and therefore balancing Hexagrams in the rising and falling sequence. The Earthly Branches also follow a sequence of Yang Hand and Foot pairs being enclosed within a Yin Hand and Foot pair. However, while it could remain consistent with this order, the Small Intestine-Liver, and San Jiao-Spleen pairs then break this pattern, being switched around. A third pattern that emerges from the placement of the San Jiao and Large Intestine is an anatomical one. This conveniently places each of the arm Luo points opposite each other, but the Foot Yin are all on the medial side of the leg making the Foot channels arbitrary. Any one of these, or a combination of the above may be behind the sequencing, but the symptoms in the Ling Shu 10, discussed below, may imply that balancing Hexagrams is the most likely. This may also connect them with the more ancient precursors of acupuncture that would use stone needles to perform ritual blood sacrifice in order to correct imbalances between the individual and cosmic realms.

In mordern practice, the Luo also have Transverse Pathways that connect the Yin and Yang pairs of the same element, meaning that the health of one can be detected in the other. This does not seem to be very well supported by the Ling Shu ch. 10 which seems to use opposite Earthly Branches connections, but also gives the example of using the veins in the thenar eminence of the hand at 魚際 Yuji Lu-10, along the Lung Luo, to diagnose the state of the Stomach. A Stomach-Lung connection would have to operate via a Stomach-Large Intestine (Yangming), then Large Intestine-Lung (Metal) pathway, or a Taiyin connection to the Spleen and then Earth connection to the Stomach. Alternatively, it is not difficult to see how the veins of the wrist run into the palm and thenar eminence, and this connection would have been equally apparent to the author, so it is possible that a Stomach-Pericardium connection is implied, which then transmits itself to the thenar eminence and Lung Luo. Since the logic is never explained, it is only possible to speculate this relationship.

Symptoms

Symptoms associated with the Luo are first given in Su Wen ch. 63 but only for some, and only generic symptoms. A more detailed description is given in Ling Shu ch. 10 which provides symptoms associated with each Luo in a state of repletion, depletion and, in the case of the last four, rebellion. Repletion suggests an Excess state where the blood vessels appear along the trajectory, while depletion suggests a Deficiency of Blood and perhaps pallor or an absence of visible vessels. Rebellion appears to be related to a particular direction of ciruclation becoming reversed.

The reason for certain symptoms being associated with certain Luo is never clearly explained. My own interpretation is that the Luo are connecting vessels and, long before the modern tradition of connecting the Zang and Fu pairs of each element, the connected opposing Earthly Branches, using Blood to act like a shock absorber to hold a surplus or draw from to supplement a deficiency in its opposing Earthly Branch. Thefore, for example, if there is an Excess in the Lung, it can direct it to the Bladder Luo causing this channel to become engorged. If Excess is too great for the Bladder Luo to store, then the Lung no longer has a buffer to store its Excess and the nose become blocked. It is therefore possible to bleed the Bladder Luo to release the stored Excess and enable it to accept more. If the Lung is deficient, the Bladder may try to send some of its Blood supply to the Lung. If this is not enough, the Exterior barrier of the Lung continues to be Deficient and Blood runs out. It may be possible to bring more Blood to the Bladder Luo to support the imabalance temporarily using moxa, although Ling Shu 10 only describes bleeding excesses.

Emotional symptoms are noticeably absent from Ling Shu 10 and some schools of read these as metaphorical or somatised emotional states but other sections of the Neijing do not shy away from describing the effects of emotion, so it is questionable why these descriptions are made into cryptic metaphors in a chapter specifically on emotionally caused disease. However, the Su Wen ch. 62 says:

and Su Wen ch. 63 describes Luo pathology as describing "Strange Diseases (奇病 Qi Bing)" which imply something spiritual, supernatural or, in todays terms, psychological so psychological symptoms. For this reason I have included a commentary for each one that consists of a purely physiological-philosophical mechanism based on the mechanism outlined above, followed by how these can be read as metaphorical emotional states for those who wish to interpret them in that way.

Classical Treatment

The main method of treatment recommended for the Luo in Ling Shu ch. 10 is to "pierce wherever knots have formed and there is Excess Blood (必刺其結上甚血者 Bi Ci Qi Jie Shang Shen Xue Zhe). Even if no knots have formed, it must be removed quickly, so drain the Evil by removing the blood (雖無結急取之以寫其邪而出其血 Sui Wu Jie, Ji Qu Zhu, Yi Xie Qi Xie Er Chu Qi Xue). Mostly this is interpreted as clusters of spider veins today and varicose veins should be avoided as piercing them can aggravate or cause infection. The traditional method was to use a triple-edged needle but modern schools tend to use lancets, plum blossom or seven star hammers, derma rollers and other tools that cause bleeding. There is no reason why a thick needle, inserted shallowly and without retention, cannot also be used, providing the point bleeds.

Su Wen ch. 63 advises "misleading percing (繆刺 Mou Ci)" and gives some specific symptoms and treatments for some of the Luo. However, many of the locations to pierce are Jing-Well points which may suggest that this chapter was a earlier prototype explaining the theory behind the more complete and systematic description of the Luo, their pathways and symptoms given in the Ling Shu ch. 10. The technique of "misleading percing" is described as piercing points on the opposite side to which the symptoms appear. This is generally taken literally, especially where there are visible signs of Luo involvement on one side, but the symptoms appear on the other. However, many of the symptoms are central or systemic leaving a question of which side to pierce in the case of pain in the diaphragm, abdominal bloating, heavy headedness, etc. It could also be taken metaphorically, in relation to the Earthly Branches, as the symptoms in Ling Shu ch. 10 imply: that one pierces the channel that is opposite on the Earthly Branch cycle. Ling Shu ch. 10 makes no reference to "misleading piercing", only suggesting bloodletting wherever "knots have formed and there is excess Blood" which may make the Earthly Branch opposites seem a more inviting interpretation if the two chapters are to be reconciled.

Other Methods

Techniques that move the Blood and produce visual changes in the circulation can also be considered to be working on the Luo Mai. Ling Shu ch. 78 suggests massage (按摩 An Mo) and liniments (謬藥 Miu Yao, lit. "false medicines" because they do not address root patterns) for treating pain of the Sinews and Vessels (筋脈不通 Jin Mai Bu Tong). The Heart governs Blood and controls sweating and Ling Shu ch. 18 says, "if we take Blood there is no sweat, if we take sweat there is no Blood" showing that Blood and sweat are from the same source. This means that it is possible to treat the Luo through promoting its natural exit route, bringing Pathogens to the Sinews via the small Luo that nourish and support them and expelling them through sweating. It also says that this is caused by a "lack of Benevolence" (不仁) which may show an early awareness of therapeutic touch in psychological disorders. Treatment methods developed later that bring Blood to the surface such as cupping or Gua Sha can be seen as methods specifically designed to achieve this, drawing the Pathological Blood in the Luo to the subcutaneous region of the Sinews where they can be released naturally or artificially.

Some modern aspects of life that revolve around blood can also be considered. Many people who self-harm with cutting describe seeing the blood as a requisite for the an emotional release (Gregory & Mustafa, 2012). The most common areas are the forearms and inner thighs, which are along the pathways of the Pericardium and Liver Luo. The Ling Shu ch. 8 implies that emotions primarily originate in the Heart and Liver making these Vessels the obvious choice for emotional release. Blood donation also commonly draws blood from the cubital vein in the elbow crease where the Pericardium channel runs. Blood donation has been suggested as a means to lower microplastic "forever chemicals" in the blood (Gasiorowski et al., 2022), which may be connected to neurodevelopmental disorders (Oh et al., 2022; Zaheer et al., 2022). The oxidative reactions that occur during bruise formation and recovery can also be considered. The heme released in a bruise creates a high oxidative stress environment to make a more hostile environment for any foreign organisms that may enter through damaged skin, which is then subsequently broken down into antioxidative compounds bilirubin and biliverdin that promote healing and recovery (Jeney et al., 2013; Lowe, 2017).

It is also be possible to use them entirely diagnostically and work directly on its opposite Earthly Branch primary channel or a common root that could be transferring to the systems observed. Removing the Excess from the Zangfu at the root of the excess will resolve the imbalance and the Luo will empty by itself. Since these are only temporary buffers for imbalance, when the Su Wen ch. 24 says:

the first step is simply allowing for greater resiliance to the imbalance, while the remaining steps are treating the root. Su Wen ch. 5 says "To treat disease, you must seek its root," meaning that if bloodletting is inappropriate for any reason, you can always treat the root and use the Luo to evaluate your success.

To give a clinical example, when a patient arrived with unusually full veins on the hands and backs of the forearms (Large Intestine and San Jiao Luo), and clear signs of Yin Xu Heat and excessive rumination affecting the Blood, it could be calculated that, since the opposite Earthly Branches are the Kidneys and Spleen, that the Luo were providing temporary holding spaces for the excesses of these Zangfu (Blood Stasis and Heat). Since they were the main veins and not spider veins, bleeding was inappropriate, so treatment focused on clearing Xu Heat, resolving Blood Stasis and supplementing the Kidneys. The efficacy of the treatment could be measured by the degree to which the veins lessened in prominence during and after the session. Body builders who train to achieve muscle mass (flesh = Spleen) to the point of Blood Stasis and Kidney exhaustion also get this pattern.

手 太陰 肺 絡
Hand Taiyin Lung Luo

Ling Shu ch. 10 describes the symptoms as:
Repletion: The hands are sharp (手銳 Shou Rui) and the palms are hot (掌熱 Zhang Re)
Depletion: The patient yawns and breathes with their mouth open (欠㰦 Qian Qu), and urinates frequently passing only small amounts (小便遺數 Xiao Bian Yi Shu)

The Lung Luo receives Excess from its opposite Earthly Branch, the Bladder, and so, when replete, is receiving Blazing Ming Men Fire, causing the palms to become hot. When depleted there are signs of fatigue, yawning and frequent urination, suggesting an inability of the Kidneys to grasp the Lung Qi and regulate the waterways efectively.

The Lungs house of the Corporeal Soul (魄, Po), which the Su Wen ch. 5 says is harmed by sadness (憂) while the Ling Shu ch. 8 says boundless happiness and joy (喜樂無極) will harm the Po. Su Wen ch. 39, says elation (喜) causes the Qi to becomes loose, relaxed and slow (緩) while sadness (悲) causes the Qi to disappear (消). These both suggest an excessive attachment to the material world causes a dispersal of Qi resulting in excessive grasping and increased circulation in the hands making them red and hot. If exhausted then the Pathogen can ascend the channel and weaken the Lungs and harm the Po, making them become tired with the world, yawning and being out of breath easily. The effects on urination suggests refers to the Lungs role is causing water to descend and implies repeated failed attempts to let go of things we no longer need.

Among the emotions mapped by Nummenmaa et al., (2014), the hands see extra activation in anger, fear, disgust, happiness, love, contempt and pride.

Longitudinal:
Lu-7: 列缺 Lieque
Lu-10: 魚際 Yuji
Pc-8: 勞宮 Laogong

Transverse:
Lu-7: 列缺 Lieque
LI-4: 合谷 Hegu

手 小陰 心 絡
Hand Shaoyin Heart Luo

Ling Shu ch. 10 describes the symptoms as:
Repletion: A feeling of fullness in the diaphragm (支膈 Zhi Ge)
Depletion: Inability to speak (不能言 Bu Neng Yan)

The replete pathology of the Heart may suggest an opposite Earthly Branch connection to the Gall Bladder with fullness in the diaphragm, located under the ribs. Its depletion suggests that Blood fails to reach the tip of the channel to nourish the tongue, while also maybe indicating a loss of the Gall Bladder's function to have courage and make decisions, so the patient is falls silent.

The Heart is concerned with conenction to others so its pathologies imply either a need to express ourselves and connect. When it is replete, there is a fullness in the diaphragm as we long to express ourselves, but when empty, we may give up on attempting to communicate.

Most of the emotions described by Nummenmaa et al., (2014) involve activation of the chest area and head, but love in particular involves activation of the inner sides of the arms, chest and head, along with the genitals suggesting joint actication of the Liver Luo.

Longitudinal:
He-5: 通里 Tongli
He-1: 極泉 Jiquan
Lu-2: 雲門 Yunmen
St-11: 氣舍 Qishe
Bl-1: 睛明 Jingming
St-1: 承泣 Chengqi
St-5: 大迎 Daying

Transverse:
He-5: 通里 Tongli
SI-4: 腕骨 Wangu

手 厥 陰 心 主 絡
Hand Jueyin Pericardium Luo

Ling Shu ch. 10 describes the symptoms as:
Repletion: Pain in the Heart (心痛 Xin Tong)
Depletion: The head becomes stiff (為頭強 Wei Tou Qiang)

The Heart in Chinese medicine classics often referred to the solar plexus region, as seen by formulas like the "Drain the Heart Decoction" family which resolve distention in the epigastric region. Hence, this Luo is receiving Excess from the Stomach which is causing heart pain. The depleted symptom suggests Blood deficiency in the Stomach channel which ascends to the head, so when it is deficient and this Luo is unable to correct the balance, the neck becomes and stiff.

As the Heart Protector the psychological interpretations of the Pericardium Luo are quite obvious. When hurt we feel a pain in the Heart. If hurt repeatedly and we give up, then we hang our head in despair.

Like the Heart Luo, most of the emotions described by Nummenmaa et al., (2014) involve activation of the chest area, but love in particular involves activation of the inner sides of the arms and chest, along with the genitals suggesting joint actication of the Liver Luo.

Longitudinal:
Pc-6: 內關 Neiguan
He-1: 極泉 Jiquan
Pc-1: 天池 Tianchi
Ren-17: 膻中 Shanzhong

Transverse:
Pc-6: 內關 Neiguan
SJ-4: 陽池 Yangchi

手 太陽 小腸 絡
Hand Taiyang Small Intestine Luo

Ling Shu ch. 10 describes the symptoms as:
Repletion: The joints relax (節弛 Jie Chi) and the elbows no longer function (肘廢 Zhou Fei)
Depletion: Swelling and nodules like warts on the hands grow (生肬 Sheng You), especially small red itchy ones at the fingers resembling scabies (小者如指痂疥 Xiao Zhe Ru Zhi Jia Jie).

The Small Intestine's opposite Earthly Branch is the Liver which governs the tendons, so when it receives Excess, the joints are affected and become loose. When depleted there a lack of Blood to the hands to support Wei Qi and start to see Damp-Heat and Wind Evils accumulating in the fingers. The Liver Luo's depletion sign is also an itching skin condition.

The Small Intestine separates the Pure from the Turbid, so its emotional function is to decide what is good and bad for us, implying that in decadence we no longer discriminate between good and bad actions. In fullness we indulge indiscriminately; in emptiness we allow negative influences to settle in our body.

Among the emotions described by Nummenmaa et al., (2014), the arms are activated in the emotions of anger, happiness and pride.

Longitudinal:
SI-7: 支正 Zhizheng
SI-8: 小海 Xiaohai
LI-15: 肩髃 Jianyu

Transverse:
SI-7: 支正 Zhizheng
He-7: 神門 Shenmen

手 陽明 大腸 絡
Hand Yangming Large Intestine Luo

Su Wen ch. 63 describes the symptoms as:
Qi fullness inside of his chest. The breath is panting, there is a fullness in the upper flanks and the chest is hot inside. They may also become deaf occasionally.

Ling Shu ch. 10 describes the symptoms as:
Repletion: Tooth decay and deafness (齲聾 Qu Long)
Depletion: Teeth suffer Cold Obstruction and separate (寒寒痺隔 Chi Han Bi Ge)

The symptoms involving the teeth and hearing suggest the opposite Earthly Branch connection to the Kidneys which governs hearing, bones and teeth. The replete symptom of tooth decay may suggests Qi and Blood Stasis in this channel, resulting in clenching, grinding and eventual wearing down of the teeth and obstruction of the ear. When exhausted, the lack of Kidney Blood reaching the jaws and teeth causes Cold Bi and "separation" (maybe from the jaw, meaning looseness or loss).

Psychologically, the Large Intestine channel is mainly concerned with acceptance, rejection and release as things must pass our mouth to be accepted and be released from our anus once they have fulfilled their purpose. Grief 憂 and sadness 悲), affecting the Corporeal Soul (魄 Po) housed in the Lung can lead to attempts to fill the emotional hole through addictions, most of which enter us through the mouth or nose and can often lead to tooth decay.

Among the emotions mapped by Nummenmaa et al., (2014), many focus on the head, but particularly shame seems to highlight the cheeks.

Longitudinal:
LI-6: 偏歴 Pianli
LI-11: 曲池 Quchi
LI-15: 肩髃 Jianyu
St-5: 大迎 Daying
St-4: 地倉 Dicang
SI-19: 聽宮 Tinggong

Transverse:
LI-6: 偏歴 Pianli
Lu-9: 太淵 Taiyuan

手 少 陽 三焦 絡
Hand Shaoyang San Jiao Luo

Su Wen ch. 63 describes the symptoms as:
Throat is blocked and the tongue curls, the mouth is dry and the Heart is vexed. The outer edges of the arms ache and the hands do not reach to the head.

Ling Shu ch. 10 describes the symptoms as:
Repletion: Elbows suffer cramps (肘攣 Zhou Luan)
Depletion: Unable to contract the lower arm (不收 Bu Shou)

The Ling Shu symptoms appear to be a mirror of the Small Intestine Luo, except with opposite signs (elbow cramps instead of joints relaxing, deficiency in the lower arm instead of Pathogen invasion of the fingers). Standing opposite the Earthly Branch of the Spleen, Blood Stasis produces cramps in the flesh/muscle. Its depletion means that Blood is not nourishing the flesh causing muscle weakness and inability to contract the lower arm.

The Shaoyang channels are mainly connected with flexibility so it stands to reason that their pathologies will be with inability to move. Arms enable us to act so the Arm Shaoyang symptoms of cramping at the elbows suggests an inflexibility of action or involuntary action compelled by emotion, while inability contract suggests an inability to act at all. The symptoms of the hands not reaching the head suggest a lack of rationality in action while the mouth, throat and heart signs indicate an inexpressed vexation.

Among the emotions described by Nummenmaa et al., (2014), the arms and chest are activated in the emotions of anger, happiness and pride.

SJ-5: 外關 Waiguan
LI-15: 肩髃 Jianyu
Lu-2: 雲門 Yunmen
Lu-1: 中府 Zhongfu
St-17: 乳中 Ruzhong
Ren-17: 膻中 Shanzhong
Ren-15: 鳩尾 Jiuwei
Ren-12: 中脘 Zhongwan

Transverse:
SJ-5: 外關 Waiguan
Pc-7: 大陵 Daling

足 太陽 膀胱 絡
Foot Taiyang Bladder Luo

Su Wen ch. 63 describes the symptoms as:
Pain in the head, neck and shoulders.

Ling Shu ch. 10 describes the symptoms as:
Repletion: Nose is blocked (鼽窒 Qiu Zhi), head and back ache (頭背痛 Tou Bei Tong)
Depletion: Nosebleeds (鼽衄 Qiu Nu)

The Bladder's opposite Earthly Branch is the Lung. The replete state implies an Excess condition causing blockage and pain in the Exterior. The depleted state suggests a Deficient Exterior in the nose, allowing the leakage of Blood.

Taiyang is concerned with protecting us from external threats, both with immune reactions against invisible threats, but also movement to avoid or attack visible ones. The trajectory indicates this latter, connecting to the calf and suggesting being constantly ready to run or fight. As the Yang aspect of the Kidneys they have a close relationship to the adrenals and these may indicate states of adrenal overstimulation and exhaustion.

Among the emotions described by Nummenmaa et al., (2014), the emotions of fear and axiety particularly focus on the chest. The close similarity of this Luo and the Kidney Luo suggests these often work as a pair.

Longitudinal:
Bl-58: 飛陽 Feiyang
Kid-4: 大鐘 Dazhong
Ren-14: 巨闕 Juque
Kid-21: 幽門 Youmen

Transverse:
Bl-58: 飛陽 Feiyang
Kid-3: 太谿 Taixi

足 少陽 膽囊 絡
Foot Shaoyang Gall Bladder Luo

Su Wen ch. 63 describes the symptoms as:
Pain in the flanks so that he is unable to breathe, coughs and sweats, or persistent pain in the hip such that the thigh bone cannot be raised

Ling Shu ch. 10 describes the symptoms as:
Repletion: Fainting (厥 Jue)
Depletion: impotence or paralysis (痿躄 Wei Bi) with inability to sit upright (坐不能起, Zuo Bu Neng Qi)

The Gall Bladder Luo should be receives Excess from its opposite Earthly Branch, the Heart, so its symptoms mimic the Stomach Luo and Percardium, except more extreme. Hence, in Excess it causes loss of consciousness instead of deranged consciousness, while in deficiency, there is complete paralysis and loss of function of the legs and lower body instead of just wasting of the lower legs and feet.

The Gall Bladder is described as the judge in the Su Wen ch. 8 and the Liver houses the Ethereal Soul (魂, Hun) which makes plans for our life and dreams. When excessive frustrations agitate the Liver, its emotional overflow into the Gall Bladder Luo causes impaired ability to make a decision and walk down a specific path. Excess suggests an inability to choose a path, while depletion will result in paralysis, the feeling that we are out of options and have no path we can take on our own volition.

Nummenmaa et al., (2014) found that anger was the only emotion where the feet had significant mapping, along with the upper body, arms and chest that is reached by the Stomach and Pericardium Luo which are involved in many emotions and have their own relationship to the Liver (Wood-Earth controlling cycle and Jueyin pair).

Longitudinal:
GB-37: 光明 Guangming
St-42: 沖陽 Chongyang

Transverse:
GB-37: 光明 Guangming
Liv-3: 太沖 Taichong

足 陽明 胃 絡
Foot Yangming Stomach Luo

Su Wen ch. 63 describes the symptoms as:
Stuffy nose and nosebleed and the upper teeth become cold.

Ling Shu ch. 10 describes the symptoms as:
Rebellion: Throat blockage (痺 Bi) and inability to speak
Repletion: Madness (狂巔 Kuang Dian)
Depletion: The feet can no longer be controlled (足不收 Zu Bu Shou) and the lower leg withers (脛枯 Jing Ku)

Yangming is often associated with manic disorders and seems to be mostly due to receiving Excess from its opposite Earthly Branch, the Pericardium. When it is full to repletion, the result is madness. Kuang Dian 狂巔 literally means "Top Dog Head" illness implying acting like an aggressive animal. When exhausted there is a lack of circulation to the extremities and the feet start to suffer sign of cardiac weakness. In rebellion, the Stomach Qi ascends and stagnates in the throat resulting in a blockage with the inability to speak.

Psychologically, madness is self-evident. in depletion, the person paces restlessly and wanders aimlessly as the Intent (Yi, 意) withers. A throat blockage may be referring to stifling our self-expression.

Nummenmaa et al., (2014) found many emotions produce changes in the head, which is served exclusively by the Yangming Luo of the Stomach and Large Intestine suggesting a role of these Luo in a number of different emotions and perhaps the Stomach especially as it relates to Earth, the centre, and so receiving the excess of any perturbation in emotional equilibrium. This is described in the Ling Shu ch 10, where the Stomach Luo trajectory travels "upwards to the head and neck, where the Qi of all the channels is brought together."

Longitudinal:
St-40: 豐隆 Fenglong
St-13: 氣戶 Qihu
Du-20: 百會 Baihui
St-9: 人迎 Renying

Transverse:
St-40: 豐隆 Fenglong
Sp-3: 太白 Taibai

足 太陰 脾 絡
Foot Taiyin Spleen Luo

Su Wen ch. 63 describes the symptoms as:
Lower back pain pulling on the lower abdomen and drawing on the lateral abdomen so that they cannot breathe in an upright position.

Ling Shu ch. 10 describes the symptoms as:
Rebellion: Vomiting and diarrhoea ("Sudden Turmoil") (霍亂 Huo Luan)
Repletion: Cutting pain in the intestine (腸中切痛 Chang Zhong Qie Tong)
Depletion: Abdomen swells like a drum (鼓脹 Gu Zhang)

Stagnation in the Middle causes knotting of Qi. When this involves Blood Stasis, there is cutting abdominal pain. If empty, the Spleen cannot function fully causing Dampness to obstruct it, leading to further obstruction and resulting in bloating to the point of the skin being stretched like a drum. Its opposite Earthly Branch, the San Jiao, is the origin of waterways suggesting that if Spleen Luo is insufficient, it no longer provides the movement to Water and the overflow will accumulate leading to drum distention. If the Spleen rebels, whose natural energy is the centre, then there is inability to contain the food resulting in episodes of Sudden Turmoil.

The Spleen houses our ability to concentrate (意, Yi) and is most affected by worry or overthinking (愁憂 Chou You) which Su Wen ch. 39 says knots the Qi. This can manifest in a number of digestive issues associated with anxiety like butterflies in the tummy, knotting pain, bloating and loose stools.

Nummenmaa et al., (2014) maps several emotions to the abdomen, including fear, anxiety, disgust, shame as well as happiness and love, suggesting a role of the Spleen Luo in all these states which shift us away from emotional equilibrium.

Longitudinal:
Sp-4: 公孫 Gongsun
Ren-12: 中脘 Zhongwan

Transverse:
Sp-4: 公孫 Gongsun
St-42: 沖陽 Chongyang

足 少 陰 腎 絡
Foot Shaoyin Kidney Luo

Su Wen ch. 63 describes the symptoms as:
Sudden heartache and violent distension with fullness of the chest and flanks. They may also have pain in the throat so that they are unable to take in any food. They will be angry without cause as the Qi moves upwards to above the diaphragm.

Ling Shu ch. 10 describes the symptoms as:
Rebellion: Vexation and heart pressure (煩悶 Fan Men).
Repletion: Closure with urinary retention (閉癃 Bi Long)
Depletion: Lower back pain (腰痛 Yao Tong)

The Kidneys draw Excess from its opposite Earthly Branch, the Large Intestine so their repletion pattern is one of the lower orifices closing from obstruction. When depleted there is a lack of Blood to the Lower Jiao and so the lower back aches. Its symptoms from Su Wen 63 and rebellion in Ling Shu 10 appear to relate to its its trajectory and Shaoyin paired organ, the Heart, causing symptoms of heartache, fullness and pressure with emotional disturbance as Blood does not follow the correct movement of water, which is to descend, and instead rises back up to the Heart.

The Kidneys are related to fear and the Ling Shu ch. 8 says that fear and anger come from the deficiency and fullness of the Liver. Fear from Liver deficiency makes the Qi sink and its stagnation in the Lower Jiao will cause urinary stagnation, damage to the Essence (精Jing) and eventual masses. Anger from Liver Excess draws on Water to fuel the demands of Wood while causing the Qi to rise, resulting in a deficiency of the Lower Jiao and exhaustion of the Kidneys with lower back ache. Exhaustion of the Will (志, Zhi) results in inability to stand up for oneself. The nature of the Kidney Qi is to descend for elimination and so its rebellion with cause Water Qi to put pressure on the Heart causing vexation and a sense of pressure. Likewise, suppression of fear and anger will mean the Kidneys no longer take the burden of the emotions originating in the Liver and instead affect the Heart leading to anxiety and depression with a feeling of pressure on the chest.

Among the emotions described by Nummenmaa et al., (2014), the emotions of fear and axiety particularly focus on the chest.

Longitudinal:
Kid-4: 大鐘 Dazhong
Ren-14: 巨闕 Juque
Kid-21: 幽門 Youmen

Transverse:
Kid-4: 大鐘 Dazhong
Bl-64: 京骨 Jinggu

足 厥 陰 肝 絡
Foot Jueyin Liver Luo

Su Wen ch. 63 describes the symptoms as:
Sudden hernia and violent pain (暴痛).

Ling Shu ch. 10 describes the symptoms as:
Rebellion: Swollen testicles (睪腫 Yi Zhong) and hernia (卒疝 Zu Shan)
Repletion: Persistent erection (挺長 Ting Zhang)
Depletion: A violent itch (暴癢 Bao Yang)

The Liver Luo's trajectory makes an obvious connection to sexual arousal. Being opposite the Earthly Branch of the Small Intestine, which is the elemental pair of the Heart, also seems to suggest a relationship to finding a sexual partner we can connect with. When in Excess there is a persistent erection impying sexual obsession and indiscriminate promiscuity without the ability to connect emotionally. When depleted the lack of blood in the Luo leads to dryness, Wind and a violent itch. Notably, the Small Intestine Luo is the only other to feature a symptom of itching in deficiency, further strengthening the notion that the Luo connect these opposites.

The Liver houses the Ethereal Soul (魂, Hun), the part of us that floats out of our body in dreams and trances. Therefore the normal function of the Luo is to enable us to fantasize sexually and send blood to the genitals when required. Hence, if our sexual identity is damaged it may result in sexual pathologies. A full Luo presents as a unquenchable sexual appetite, while emptiness suggests a kind of Sadean exhaustion wherein one engages but is never satisfied, leading to increasingly fetishistic and risky behaviours, potentially contracting STDs, as we attempt to satisfy these urges. The violence and brutality (暴 Bao) of the itch or pain imply cruelty and sadism from a frustrated sex drive. Suppression of sexual desire results in somatic manifestations of the genitals such as genital swellings and violent suffering.

The only emotion mapped by Nummenmaa et al., (2014) to the gentials is love.

Longitudinal:
Liv-5: 蠡溝 Ligou
Ren-2: 曲骨 Qugu

Transverse:
Liv-5: 蠡溝 Ligou
GB-40: 丘墟 Qiuxu

Extraordinary and Great Luo

Ren Luo

Ling Shu ch. 10 describes the symptoms as:
Repletion: Abdominal skin aches (腹皮痛 Fu Pi Tong)
Depletion: Itching (痒搔 Yang Sao)

The Extraordinary Luo do not so much seem to connect with their opposite than act additional buffers for the essential Shaoyin axis. Hence the Ren Mai Luo appears to take excess or support deficiency from the Heart. When full, an aching pain is felt in the abdomen and when depleted, there is itching, a classic sign of Heart pathology from Su Wen 74 which says: "All pain, itching and sores, without exception, is associated with the Heart."

Psychologically, in both cases the impression is of feeling uncomfortable in one's own skin.

Ren-15: 鳩尾 Jiuwei

Extraordinary Du Luo

Ling Shu ch. 10 describes the symptoms as:
Repletion: The back is stiff (脊強 Ji Qiang)
Depletion: The head feels heavy (頭重 Tou Zhong), it shakes (高搖之 Gao Yao Zhi), and those who go through it grasp their spine (挾脊之有過者 Xie Ji Zhi You Guo Zhe)

The Du Mai seem to be providing additional balance to the Kidneys. When in excessive it becomes rigid and inflexible and when deficient it results in weakness of the muscles of the back resulting in pain and trembling.

Psychologically, these can be interpreted as over-assertion, even when its not called for when replete, and a lack of backbone when exhausted, making us lose our will to fight and hang our head in despair.

Du-1: 長強 Changqiang
Ex-BW-2: 華佗夾脊 Huatuojiaji
Bl-10: 天柱 Tianzhu
Bl-1: 睛明 Jingming

Great Spleen Luo

Ling Shu ch. 10 describes the symptoms as:
Repletion: Entire body aches (身盡痛 Shen Jin Tong)
Depletion: All the joints relax (百節盡皆縱 Bai Jie Jin Jie Zong)

The symptomology of this Luo, with visible veins appearing on the lateral costal region accompanied by whole body aches or fatigue, may have been an early description of hepatitis or other chronic liver disease. The attribution to the Spleen instead of the Liver was common in ancient times as the accompanying yellowing of the skin was seen as a sign of Earth/Spleen disharmony.

As a psychological metaphor, the Great Luo of the Spleen is said to become filled when the others cannot contain the Pathogen so its symptomology relates to the whole body. When full, all of life becomes painful, when exhausted the person gives up. Notably, 身 Shen, "body" and 節 Jie, "joints" can be translated as "moral character" and "integrity" giving the symptoms of the Great Spleen Luo an ethical dimension. They can be therefore be translated as "moral character is exhausted and hurt" and "all integrity dies and everything is let loose" suggesting maintaining ones morality under duress and giving in to decadence.

Sp-21: 大包 Dabao

Great Stomach Luo

The Ling Shu does not mention this vessel but the Su Wen ch. 18 refers to an additional collateral called Xu Li (虛裡, the "Empty Mile"), suggesting it is activated when the Luo system is exhausted. Its associated symptoms of chest congestion and irregular breathing or palpitations and its location at the apical pulse found below the left breast suggest severe heart disease. As a psychological metaphor, this indicates that the pathology has been passed to the Extraordinary Vessels.

Ren-12: 中脘 Zhongwan
St-18: 乳根 Rugen

Hand Taiyin Lung Opens 3 - 5 am ䷊ Radial	Hand Shaoyin Heart Pivots 11 am - 1 pm ䷫ Ulnar	Hand Jueyin Pericardium Closes 7 - 9 pm ䷖ Flexor
Hand Taiyang Small Intestine Opens 1 - 3 pm ䷠ Ulnar	Hand Yangming Large Intestine Closes 5 - 7 am ䷡ Radial	Hand Shaoyang San Jiao Pivots 9 - 11 pm ䷁ Extensor
Foot Taiyang Bladder Opens 3 - 5 pm ䷋ Lateral / Posterior	Foot Shaoyang Gall Bladder Pivots 11 pm - 1 am ䷗ Lateral	Foot Yangming Stomach Closes 7 - 9 am ䷪ Anterior, slightly lateral
Foot Taiyin Spleen Opens 9 - 11 am ䷀ Medial	Foot Shaoyin Kidney Pivots 5 - 7 pm ䷓ Medial	Foot Jueyin Liver Closes 1 - 3 am ䷒ Medial

Acupuncture Points Notebook

絡 脈 Luo Mai: Network Vessels