Part 7: Do Meridians lines lie in fascia?
Fung (2009) hypothesized that TCM meridian system upper boundaries are the skin with dense sensory receptors of various types, while the lower boundaries are another layer of connective tissue with intersititial fluid flowing through. Numerous other studies suggest the most probable location is the fascia just beneath the subcutaneous tissue. Fascia is found throughout our body creating continuity between tissues enhancing body function and support. Classical historical text of the Yellow Emperor of Internal Medicine (Unknown Author, 1931) explanation of where meridians lie states;
“Following the course of each of the meridians there are vital points (365) for acupuncture. Meridians are deeply embedded in the muscles beneath the skin; at point 365, however, they emerge to the surface and thus present the points for needling”.
Another description says that the;
“Twelve meridians travel between white and red meats. It is deep not being
able to be visible”.
Fascia is found throughout our body. It is an active structure which is virtually inseparable from our body structures providing functional stability to organs and mobility. In 2007 the First International Fascia Research Congress recognised its key characteristic being a continual uninterrupted, three-dimensional web-like structure. Under the umbrella of fascia was included, joints, organ capsules, muscular septa, ligaments, retinacula, aponeurosis, tendons, neurofascia and other fibrous collagenous tissue.
- Traditionally fascia has been grouped in relation to the region it is found, while more recent literature suggests grouping it according to function; connecting and
- Fascia is optimally designed to take up tension forces through antagonist and synergistic muscle groups in the musculoskeletal system.
- Fascia has sensory nerve fibres which contribute to nerve function and potentially to manual, temperature and vibration stimuli. One scientific model also proposes an alternative explanation for referred pain distribution based on facial connections with various nerve units.
Microscopic examination shows that fascia is a form of connective tissue. The functional properties of fascia are reliant on the type and combination of collagen protein which determines its resistance to stretch and tension and facial integrity. Fibroblast cells within the fascia are highly adaptable and able to remodel according to mechanical stimuli, while myofibroblasts demonstrate a contractile property. In response to biomechanical tension or compression, cellular changes occur including the release of biochemicals. Similarly local tissue injury via mechano transduction stimulates the formation of fibroblasts, a mechanism that has been linked with embryonic development. There is evidence to suggest that the insertion and manipulation of acupuncture needles into the fascia (causing strain on the tissue) stimulates fibroblastic activity.
The chemical structure of facial proteins is very similar to that of organic polymer which has good semiconductor properties. It also has an ideal organic liquid crystal chemical property which exhibits double refractive light properties. A study using digital anatomical dissection methods analysing three-dimensional fascia of the human body found a pearl-like chain similar to the meridians. They concluded that beyond the supportive function the fascia is also a storage, self-monitoring and self-adjustment system. On the basis of anatomical, biophysical evidence of low electrical resistance, high acoustic, illumination and thermal lines only found in tissue with semi-conductor properties Chen (2008) concluded that fascia was the most likely structure where meridians may lie. He also uses its continuation from superficial to deeper tissue and internal organs to explain why there is an enhanced feeling of Qi flow during qigong practice when in a state of complete relaxation, and the reverse when there is anxiety, tension or other high emotional states.
In the ancient Chinese book of Miraculous Pivot it is stated, “acupuncture does not take effect until the arrival of qi’. The effectiveness of an acupuncture treatment is determined not just by the meridian but also the selection of acupoints and the phenomenon of ‘Arrival of Qi’. Arrival of Qi is described as a sensation of soreness, numbness or distension at the needle site. Factors influencing arrival include accuracy of acupoint location, needle insertion depth and needle manipulation. In the next part of our series we try to break down the science behind the ‘arrival of qi’ and its importance.
In Part 8 we will discuss, Arrival of Qi (De Qi)
Part 1: How Does Acupuncture Work?
Part 2: Qi: Vital Energy, Life Force
Part 3: Five Elements Theory
Part 4: Chinese Diagnosis
Part 5: Integrating Western Physiology with TCM Philosophies
Part 6: TCM Meridians