Flashcards in Lecture 5: Dai Mai Deck (61):
The Dai Mai or the "_______ _________" is the only _____________ vessel of the body. Because it encircles the channels in the abdomen and back like a belt, it divides the body in _____ ______.
Girdle Vessel; horizontal; two halves
What are all of the translations of dai?
belt, girdle, "to bear," "to carry"
There is a theory that the Dai Mai was regarded as the _______________ support structure. There are further references that the pelvic structures ________ or ______ the upper half of the body and that the ___________ abdominus muscles _____ the internal organs as well as the fetus.
musculoskeletal; support; carry; transversus; carry
The Dai Mai conducts the qi of the whole organism in the _________ direction and to its ______ destination.
What is the opening/master/confluent point of the Dai Mai? What are its other hats?
G41 Zulinqi (Foot Governor of Tears)
1) Master Point of Dai Mai
2) Shu stream
3) Wood point of G channel
Where is the master point of Dai Mai located?
G41 located in the depression distal to the junction of the 4th and 5th metatarsal bones, on the lateral side of the tendon of m. extensor digitorum longus (branch to little toe).
How do you needle the master point of Dai Mai?
Perpendicular insertion 0.5-1 cun
Ask the patient to abduct their little toe in order to make the branch of m. extensor digitorum longus more prominent. Run a finger from G43 towards the ankle, along the interspace between the fourth and fifth metatarsals until it passes over this branch into the significant depression immediately beyond the tendon.
What is the couple point of Dai Mai? What are its other hats?
TE5 Waiguan (Outer Pass)
1) Master point Yang Wei
2) Coupled point Dai Mai
3) Luo connecting point of SJ Channel
Where is the couple point of Dai Mai, or Master point of Yang Wei, located?
TE5 located 2 cun proximal to TE4, in the depression between the radius and ulna, on the radial side of the extensor digitorum communis tendons.
How do you needle the couple point of Dai Mai (Master point of Yang Wei)?
Slightly oblique insertion towards the ulnar side or oblique proximal or distal insertion towards the elbow or wrist respectively 0.5-1 cun.
What is the trajectory of Dai Mai?
The Dai Mai originates in the hypochondrium and flows through LV13 Zhangment and then connects with G26 Daimai, G27 Wushu and G28 Weidao. In the back it connects with the Kidney Divergent Channel at the level of B23 Shenshu.
Describe the Kidney divergent channel that connects with Dai Mai.
Kidney Divergent channel departs from the kidney meridian in the popliteal fossa and crosses the Divergent Bladder Meridian on the thigh. Running upward it connects with the Kidney and crosses Dai Mai at about the level of L2. It then ascends to the root of the tongue and emerges at the posterior neck to join the UB meridian.
What points make up the Dai Mai channel?
LV13, G26, G27, G28
What are the clinical applications of the Dai Mai?
1) Harmonize LV and GB
2) Resolve Dampness in the Lower Burner
3) Regulate circulation of Qi in the legs
4) Full/Empty pathology
5) "Modern Stress Disorder"
Association and treatment areas?
2) Abdominal pain
3) Hip pain
EXAM: The Dai Mai can be used to harmonize the __________ and __________ particularly in ____ patterns such as what? (Name 3)
Liver; Gallbladder; Full
1) Liver Qi Stagnation
2) Liver Fire
3) Gallbladder heat
How would you differentiate between Liver Qi Stagnation and Liver Fire?
- Liver Fire is a full condition and you would see red eyes, splitting headache, red face, rapid pulse, more aggression maybe instead of just irritability, bitter taste in mouth, red tongue with dry yellow coat instead of normal tongue.
- Liver Qi Stagnation would see more irritability, depression, moodiness, hypochondriac area distention or pain, frequent sighing, feeling of lump in throat, epigastric pain, reduced appetite, normal tongue with maybe a thin white coat
How would you differentiate GB Heat and Liver Fire?
Both have a bitter taste in the mouth therefore look at location of pain. With LV Fire you would see hypochondriac area pain. GB you would see pain more on the flanks or sides.
What treatment protocol would you use for fullness and distention of the lower abdomen as seen in LV Qi Stagnation (stagnation of MJ)?
GB41 and TE5
What points would you choose for temporal headaches in the presence of LV Fire or GB heat?
GB41 and TE5
Clinical application #2: Resolve Dampness in the Lower Burner
Dampness may arise from a dysfunction of the Dai Mai.. seen in either ___ or ____ conditions and may manifest as ________ or ________ problems. What kind?
full/empty; gynecological; urinary
- excessive vaginal discharge (leucorrhea)
- difficult urination and/or burning with urination
What occurs with a full condition?
The belt is too tight and may result in stagnation of the channels leading to Dampness.
What occurs with an empty condition?
The belt is too loose meaning the leg channels are not kept in check or not restrained - the Spleen and Kidney Qi will sink and Dampness infuses into the Lower Burner.
What jiao are the intestines considered to be?
What patterns or organ systems might be involved through Zang Fu diagnosis when treating Dampness in the Lower Burner?
1) Damp Heat (eg. UTI's)
2) Cold- Damp (more contraction, pain, cloudy turbid urine)
Both can be internal or external.
1) Kidney Yang Xu
2) Spleen Yang Xu
What is your mnemonic for Dai Mai clinical application treatments?
Just go with easy breezy assonance!!
Circulate Qi (of legs)
Modern Stressfully (ee) Disordered conditions
What is your mnemonic for association and treatment?
Associate (ate) assonance
All about the pain.. (eh)
1) Hip pain
2) Abdominal pain
3) Gynecology pain and otherwise
Hag, haggle below the belt
3) Regulate circulation of qi in the legs
As the Dai Mai encircles the ____ channels an impairment of Qi circulation in the Dai will affect circulation of Qi in the ___. This would result in symptoms such as what? ____ ____ and ____ which feels like what?
- cold legs and feet
- like sitting in cold water
- purple feet
- tense outer leg muscles (due to Liver Blood not moistening sinews)
What do we need to differentiate in terms of purple feet?
Need to know if this is Dai Mai or Chong Mai. If it is Chong Mai we should look for more symptoms of stasis.
In what situation would we use Dai Mai along with Chong and Du Mai?
Atrophy (Wei) Syndrome as seen in Multiple Sclerosis
A statement in the Su Wen states that the ________ _______ "runs to the pubic bone and the the spine in the back" suggesting that not only the rectus abdominus muscle is referenced but also the spinal muscles such as _______ _______.
ancestral muscle; erector spinae
Therefore the Ancestral Muscle (which has its insertion in the pubis) and point _____ are strategic intersections of the ______, ___ and ____ Mai.
Chong, Du and Dai
What point prescription would you choose for Atrophy Wei Syndrome (MS)?
GB41 and TE5
What are the symptoms of a full condition?
- fullness and distention in the abdomen
- back feels cold like sitting in cold water
How else might one interpret the reference to sitting in water ?
Pirog suggests that the interpretation of water may describe a cool, clammy sensation. Water may also refers to bloating or edema in the lower body.
A full pathology of the Dai Ma is also associated with a full pathology of which other EOV?
What prescription would you choose for a full pathology of Dai Mai with Dampness?
5) Modern Stressfully disordered conditions
A disorder in the Dai Mai would ____ off the flow of energy like a _________, forcing ____ to remain in the head and chest, which in turn prevents it from returning to _____ the lower extremities.
cut; tourniquet; yang; warm
The clinical scenario of modern stress disorder therefore would combine rising _____ symptoms with _____, _________ symptoms. Further it may well be that modern urban life with its continuous _______ of the __________ nervous system has altered the appearance of some cases of ______ vacuity.
yang; cold, vacuous; stimulation; sympathetic; yang
Modern stress disorder is a subset of what other condition?
Need to confirm but I believe Full condition of the Dai Mai.
In a full condition the upward rising of yang creates what condition?
Headaches and deficiency in the lower body.
What often causes PMS?
Yang rising due to yin deficiency
Case study: Person presents with pale tongue, cold extremities, weak abdomen and back, chronic leucorrhea, but the person is saying they have migraines and hypertension. What could this be?
This may be a case of continuous stimulation of the nervous system (Modern Stress Disorder). This tends to agitate the mind and keep the energy in the head. Meanwhile there is a lack of exercise and couch potato posture.
Empty (ee) condition:
The empty pathology of Dai Mai is due to ___ _________ and this vessel being too _____.
Qi deficiency; slack
What happens if the Dai Mai is too slack such that Qi cannot rise and organs sag:
- Hernias and prolapses develop
- Atrophy (Wei) syndrome develops
- Miscarriages may occur
The Empty pathology of Dai Mai is associated with an empty condition of the ____ ____.
What points would you choose for treating an empty condition of the Dai Mai?
Associations and treatment:
Hip pain. Because of the trajectory of the Dai Mai it influences the hip and is therefore incorporated in cases of hip pain - particularly when there is a condition of ________ in the ___ and the pulse is ____ on both ______ positions
Dampness; LJ; wiry; middle positions
What points would you choose for hip pain associated with the Dai Mai?
Assocations and treatment:
Abdominal pain. What are the essential characteristics of abdominal pain indicating a pathology of the Dai Mai?
- Pain is in the abdomen and radiates upward towards the back
- Pain is back and radiates downwards towards the lower abdomen
What is the laterality of abdominal pain to consider Dai Mai?
May be unilateral or bilateral.
What point prescription would you use for Dai Mai abdominal pain?
What point prescription would you choose for Modern Stress Disorder?
What type of gynaecological issue is Dai Mai important for?
Excessive vaginal discharge - leucorrhea.
What is the cause of excessive vaginal discharge in the context of the Dai Mai?
It is always owing to Dampness, either Full or Empty.
In Full conditions of dampness what is the cause and what are the symptoms?
The cause is that the Dai vessel is too tight. The Dampness therefore accumulates in the Lower Jiao with the characteristic feeling of heaviness.
What point prescription would you choose for Full Dampness of the Dai Mai causing leucorrhea?
In Empty conditions what is the cause of Dampness and what are the symptoms?
In Empty conditions the Dai Mai is too slack so that the Spleen and Kidney Qi sink leading to formation of Dampness and to a very chronic excessive vaginal discharge that is very resistant to treatment.
What point prescription would you choose for Empty Dampness of the Dai Mai causing leucorrhea?
In gynaecology excessive pathology is secondary to _______ in the ________ ____.
Excess; Chong Mai