Korean Journal of Acupuncture

Society for Meridian and Acupoint (경락경혈학회)
권호 표지
DOI QR코드

DOI QR Code

Discussion on the Route of Lung Meridian: Focus on LU3 and LU4

수태음폐경 노선에 대한 고찰: 천부·협백을 중심으로

  • Seok Mo, Song (Department of Meridian and Acupoint, College of Korean Medicine, Woosuk University)
  • 송석모 (우석대학교 한의과대학 경혈학교실)
  • Received : 2022.11.02
  • Accepted : 2022.11.28
  • Published : 2022.12.27
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : An error was found in the recent standard by the World Health Organization (WHO) on the locations of the Upper arm Route of Lung Meridian (URLM) and its acupoints LU3 and LU4. This possible incorrect information is being taught throughout Korean medicine colleges nationwide, which follow WHO standards. Therefore, an investigation is required to sort out this discrepancy based on the evidence in historical documents. Methods : The location of WHO's URLM and LU3 and LU4 were compared with corresponding information in the classical literature. The anatomical structure mentioned in these classical documents was examined. Finally, an assessment was conducted on whether this structure is reflected in the WHO standards. Results : Classical literature prior to the early 20th century records the locations of the Lung Meridian and LU3 and LU4 of the upper arm to be in the artery on the medial aspect. This artery corresponds to the brachial artery. The location established by the WHO is on the anterolateral side of the upper arm, where no large arteries exist that can be found by haptic search or angiographically. The anterolateral side of the upper arm belongs to the Yang aspect, which does not coincide with the Yin aspect of Lung Meridian. Conclusions : The WHO's URLM and LU3-4 standards do not agree with the classical literature. The correct route must coincide with the brachial artery passing through the medial side of the humerus. The actual location of LU3-4 is on the medial aspect of the arm, just medial to the border of the biceps brachii muscle, on the brachial artery, 3-4 B-cun inferior to the anterior axillary fold.

Keywords

Acknowledgement

This paper was supported by Woosuk University.

References

  1. Hebei medical academy. Miraculous pivot : collated and annotated part 1 (Lingshujing jiaoshi). 1st ed. Beijing : People's Medical Publishing House. 1985 : 263-7; 35, 58.
  2. Qiu XG. Collection of bamboo slips and silk scripts at Mawangdui Han Tomb in Changsha Vol. 5 (Changsha mawangdui hamu jianbojicheng). 1st ed. Beijing : Chung Hwa Book Company. 2014 : 206.
  3. Zhang SX. Correction and pictorial commentary on Canon of difficult questions and Pulse formula (Jiaozheng tuzhu nanjing maijue). 1st ed. Shanghai : Hongbaozhai. 1912 : 2.
  4. Wu G. Yellow emperor's canon of multitude of difficult questions (Huangdi zhongnanjing) In: Yan SY, Li QZ. Collected medical works in the Three Kingdoms, Two Jins, Southern and Northern Dynasties (Sanguo liangjin nanbeichao yixue zongji). 1st ed. Beijing : People's Medical Publishing House. 2009 : 111.
  5. Zhang CJ, Xu GQ. AB Canon of Acupuncture and Moxibustion : Collated and Annotated (Zhenjiujiayijing jiaozhu). 1st ed. Beijing : People's Medical Publishing House. 1996.
  6. Gourevitch D. The paths of knowledge: medicine in the Roman world. In: Grmek MD. Western medical thought from antiquity to the middle ages. 1st ed. Cambridge, MA, and London : Harvard University Press. 1998 : 131.
  7. Yeo IS. Zhuzhiqunzheng, the Jesuit translation of Western medicine and its influence on Korean and Chinese intellectuals. Uisahak. 2012 ; 21(2) : 251-78.
  8. Zhang SY. Collected medical works of Zhang shanlei (Zhang shanlei yiji). 1st ed. Beijing : People's Medical Publishing House. 1995 : 605-8.
  9. Mao L. Is the Meridian of moxibustion canon of the eleven meridians of the foot and arm the "sense transmission line"-discussion with comrade Meng Zhaowei (Zhubishiyimaijiujing de mai shi "ganchuanxian"ma?-yu Meng zhaowei tongzhi shangque). Shanghai Journal of Acupuncture and Moxibustion. 1985 ; 4 : 33-5. https://doi.org/10.13460/j.issn.1005-0957.1985.04.020
  10. Huang LX. An outline of the academic history of chinese acupuncture and moxibustion (Zhongguo Zhenjiu Xueshushi dagang). 1st ed. Beijing : Huaxia Publishing House. 2001 : 459.
  11. Shaw V, Diogo R, Winder IC. Hiding in plain sight - ancient Chinese anatomy. Anat Rec (Hoboken). 2022 ; 305(5) : 1201-14. https://doi.org/10.1002/ar.24503
  12. Li YM. Persistent median artery may explain the transition from 11 to 12 meridians in ancient Chinese medicine. J Anat. 2021 ; 238(6) : 1442-3. https://doi.org/10.1111/joa.13376
  13. Kumaratilake J, Lucas T, Henneberg M. Possible relationship of upper limb arteries, median and brachial to the twelfth meridian of the human upper limb. J Anat. 2021 ; 238(6) : 1492-3. https://doi.org/10.1111/joa.13401
  14. Song SM. Hand-Yin meridians of unearthed Mawangdui medical texts were described by the haptic exploration. JKMH. 2022 ; 35(1) : 87-100. https://doi.org/10.15521/jkmh.2022.35.1.087
  15. Colleges of Korean Medicine and Graduate School of Korean Medicine, Meridian and Acupoint Textbook Compilation Committee. Acupuncture points Vol. 1. 1st ed. Seoul : Jeongdam. 2020 : 2.
  16. Colleges of Korean Medicine and Graduate School of Korean Medicine, Meridian and Acupoint Textbook Compilation Committee. Meridianology. 2nd ed. Seoul : Jeongdam. 2022 : 62-3.
  17. World Health Organization Regional Office for the Western Pacific. WHO standard acupuncture point locations in the Western Pacific Region. 1st ed. Geneva : World Health Organization. 2008 : 25-7.
  18. Deng LY. Compendium of Chinese acupuncture-moxibustion meridians (Zhongguo zhenjiu jingluo tong jian) 3rd ed. Qingdao : Qingdao Publishing. 2004 : 546-52.
  19. Yun TQ. Collected medical works of Yun Tieqiao (Yun tiewio yishuheji). 1st ed. Tianjin : Tianjin Science Technology Publishing. 2010 : 930-1.
  20. Qiu XG. Collection of bamboo slips and silk scripts at Mawangdui Han Tomb in Changsha Vol. 6 (Changsha mawangdui hamu jianbojicheng). 1st ed. Beijing : Chung Hwa Book Company. 2014 : 12.
  21. Song SM. Visuality and hapticity in acupoints: a study on benshu chapter in Huangdi Neijng Lingshu. Korean J Acupunct. 2021 ; 38(4) : 290-307. https://doi.org/10.14406/acu.2021.035
  22. Nasr AY. The radial artery and its variations: anatomical study and clinical implications. Folia Morphol (Warsz). 2012 ; 71(4) : 252-62.
  23. Sushma, Kavitha K, Satheesha KS. Morphological study of brachial artery and its variations in branching pattern. Int J Anat Res 2018 ; 6(4.3) : 5963-9. https://doi.org/10.16965/ijar.2018.385
  24. Wang DS. Compendium of Chinese acupuncture-moxibustion points (2 vols.). 2nd ed. (Zhongguo zhenjiu xuewei tongjian). Qingdao : Qingdao Publishing. 2004 : 288-9.
  25. Uflacker R. Atlas of vascular anatomy: an angiographic approach. 2nd ed. Philadelphia : Lippincott Williams & Wilkins. 2007 : 390-1.
  26. Doyle JR, Botte MJ. Surgical anatomy of the hand and upper extremity. 1st ed. Philadelphia : Lippincott Williams & Wilkins. 2003 : 328.
  27. Przybycien W, Zarzecki M, Musial A, Depukat P, Kruszyna B, Mazurek A, et al. Anatomy of the deep brachial artery-general overview (cadaveric study)-discussion on terminology. Folia Med Cracov. 2021 ; 61(3) : 85-93. https://doi.org/10.24425/fmc.2021.138953
  28. Przybycien W, Wysiadecki G, Olszewska A, Musial A, Radek M, Barszcz K, et al. Diverse variants of the profunda brachii artery: A series of three cases. Translational Research in Anatomy. 2022 ; 27 : 100196. https://doi.org/10.1016/j.tria.2022.100196
  29. Szewczyk B, Polguj M, Paulsen F, Podgorski M, Duparc F, Karauda P, et al. A proposal for a new classification of coracobrachialis muscle morphology. Surg Radiol Anat. 2021 ; 43(5) : 679-88. https://doi.org/10.1007/s00276-021-02700-1
  30. Samberkar SP, Kassim NM, Zin SRM, Samberkar P. Entrapment of the median nerve by a muscular branch of the brachial artery: a case report. Forensic Medicine and Anatomy Research. 2014 ; 2(03) : 51. https://doi.org/10.4236/fmar.2014.23010
  31. Roy TS. Median nerve penetration by a muscular branch of the brachial artery. Clin Anat. 2003 ; 16(4) : 335-9. https://doi-.org/10.1002/ca.10080
  32. Kanbayashi T, Takafuji T, Sato Y. On the arterial supply in the human biceps brachii muscle. Okajimas Folia Anat Jpn. 1993 ; 69(6) : 289-310. https://doi.org/10.2535/ofaj1936.69.6_289
  33. Levangie PK, Norkin CC, Lewek MD. Joint structure and function: a comprehensive analysis. 6th ed. Philadephia : FA Davis. 2011 : 251.
  34. Palastanga N, Field D, Soames R. Anatomy and human movement: structure and function. 6th ed. London : Churchill Livingstone/Elsevier. 2019 : 125.