I do not believe that there are special channels (“meridians“) in the body for the circulation of qi (vital energy). I believe that the organisation of the body’s resources is a more intricately complex and less contrived affair than this.
This organisation is controlled by the central nervous system (CNS). It is mediated by information flow, rather than “energy” flow. Information is transmitted by means of nerve impulses, the flow of cytoplasm along neurons (axonal flow), chemical messengers, communication involving components of the immune system, and by mechanical transduction. There may be other means, some of which as yet unknown, but the word is information, not energy.
Nerves, blood and lymph vessels, and connective tissues are the structures by which this transmission is achieved. This is what we know from scientific investigation, which has found no sign of any physical structures corresponding either to meridians or to any physiological phenomena that could be uniquely related to them.
I shall hazard a guess (unverifiable alas!) that the whole theory of meridians came into being through a process of fallacious associations, perhaps such as the following. People in ancient China noticed that there were certain points on the surface of the body which seemed to be significant either in diagnosis or treatment. They also noticed that some of the points seemed to be functionally associated in some way or the other, for example in the distribution of pain. One such association they may have observed is the one we know now as myofascial trigger points and the areas to which they refer pain. An active trigger point can generate pain and activate secondary trigger points in its area of referral. They observed too the patterns of pain or sensory changes occurring in the distribution of nerves from the spine (spinal nerves) to the skin and muscles (like sciatica), and the phenomenon of pain from internal organs that is experienced in the surface structures of the body (visceral referred pain). They observed human anatomy and found organised networks of fascial planes connecting up the body. Then they simply joined the dots, in ways that seemed reasonable to them considering the symptom patterns, the topography, the anatomy, and their world view. I say they seemed reasonable. We must however allow for the human mind’s predilection for recognising meaningful patterns even where there is only randomness (apophenia). The constellations of stars in the night sky is one example of this. Just as the stars in the sky can be connected by imaginary lines to form imaginary constellations, so could the points on the body’s surface be connected to form imaginary meridians.
Thus, my contention is that disparate classes of information about body connectivity and a significant dose of fancy combined to produce maps of meridians. However, the attribution of physiological functions to meridians is a very imperfect affair. The shared association of certain functions with a discrete “meridian” is in good part a product of the imagination. The lines, as such, are imaginary: they do not exist either as structures or discrete functional entities. Even though they are supposed to denote functional arrangements, they are merely some kind of map, not the territory itself. In that respect, they are like the contour lines showing elevation on a geographical map. If you went to a hill shown on the map and dug for the lines, you would not find them, just as you cannot find dedicated qi channels (“meridians”) in the body.
I do not say this map is without use. Just like isobars on the cartographer’s map, they are indicative of the terrain even though they do not exist in the terrain! One notices on many occasions how they seem to account for some symptom pictures in the way a traditional Chinese physician may have predicted. Why does this person have a cramp-like pain half way down his left calf at the same time as he has pain in his left lower abdomen? There is, currently, a stone passing down his left ureter. I have never seen calf pain described as urinary referred pain in the Western medical literature, but to the traditional Chinese physician, it is well established knowledge that the back of the calf is on the “urinary bladder meridian”. Why has this lady who underwent cholecystectomy (surgical removal of the gallbladder) 40 years ago had pain affecting the side of her thigh and leg, first on the left, two years later on the right? It is the territory of the “gallbladder meridian”. The clinical examples are countless. However, what I do say is that the maps of meridians and their points attempt excessive precision, which can easily be interpreted too closely and too literally. It is like confusing a rough rule of thumb with a precise physical law.
To practise acupuncture just as effectively and more efficiently, I believe we would do better to refer to more realistic theories about the anatomical and functional arrangements that link the body’s surface with its wider workings. The practice of acupuncture does not necessarily have to refer to the classically described meridian system. In fact, today, I think it can be done without it, more efficiently and at least as effectively.
Adapted from my book Acupuncture: A Stress-Based Model (2019), Avicenna. Copyright © Robert Hale 2021.