Binding areas, valleys & ravines
The sinews bind in specific areas at large and small meeting points. Jié 結 meaning ‘knot’, ‘tie’, ‘joint’ or ‘connect’, includes sī meaning a ‘single thread of silk’ – also found in the character for jing 經 meaning ‘channel’ or ‘meridian’.
The second radical of the character is jí 吉 meaning ‘lucky’ – the radical depicts an axe that is not in use in relation to war, therefore no war is lucky. This suggests an association with a connective passage or to tie something together like a piece of rope.
Jié 結 binding starts from the heel then ascends, then jié 結 binds at the hollow of the knee.
Ling Shu 13
Jié 結 can also refer to stagnation:
An expert with needles eliminates the illness by inserting the needle and then wiping away dirt, therefore untying the knot.
Ling Shu chapter 1When the six fu are not in harmony, it [qi] will remain knotted together developing into paralysis or numbness.
Nan Jing 37
Unschuld translated jiéwéi tān 結為癱 as ’causing obstructive-illness’ (Nan Jing: The Classical of Difficult Issues (2nd ed), p 324). Jiéwéi 結為 means ‘relationship’, and wéi means ‘to be’ or ‘to act’. However, obstruction-illness is a misleading translation because of the use of tān 瘫 – meaning ‘palsy’, and not bì 痹, meaning ‘paralysis’ or ‘numbness’ – but not in relation to bì syndrome (painful obstruction syndrome). Jiéwéi is another example of jié 結, translating as ‘connection’.
The title of chapter 5 in Ling Shu is 根結 meaning ‘root and connection’ – suggesting the idea of holding something together. This is an important characteristic of the channel sinews and the significance of the binding areas.
Integrating these characters, in modern Chinese jiédì zǔzhī 结缔组织 means ‘connective tissue’. Individually, they mean (in order) ‘connection’, ‘forms’, ‘groups’, ‘weaves’. The connective tissue in the form of fascia and tendon forms the channel sinew as a complete pathway weaving of these pathways at the joints or on the bones.
Another word that has the same pinyin spelling and pronunciation is a different character – jié 節. However, it has similar definitions of ‘joint’, ‘node’, ‘knot’, ‘section’, ‘segment’ – and if combined with jié qi 節氣 means ‘solar term’. This is like an intersection.
Although there are differences, both jié characters offer insight into binding areas. The upper radical zhú ⺮ means ‘bamboo’ or ‘flute’ – like the ridges in bamboo that look like joints or knots. Each ridge is the beginning or end of a section. Bamboo is hollow, suggesting a passageway.
Jí 即 depicts a person kneeling and a bowl of food – its original meaning was to eat, and later developed into meaning ‘approach’, ‘reach’, ‘be near’, ‘at the moment’, ‘promptly’, ‘quickly’ or ‘immediately’.
The jié 節 [joints] intersect at the 365 gatherings. It is important to gain knowledge – one will discuss this in the end. To not understand restricts, leading to a scattering of explanations. The jié 節 [joint] is the location of the spirit qi that circulates, entering and exiting. They are not affected by the skin, flesh, tendons or bones.
Ling Shu 1
The large (gu) meeting points are valleys, and small (xi) meeting points are ravines. These are located at joints or bones at the origin or insertion of the muscle by the tendon. It is a passageway for the wei and ying qi (Su Wen, vol 2 (1st ed), p 56).
Maoshing’s translation of the Su Wen chapter 58 describes the xi and gu areas as large and small clefts where the bundles of muscles meet. They are located where there is an indentation and are connected to the points (The Yellow Emperor’s Classic (1st ed), p 203).
Gu valleys are found in the shoulder, elbow and wrist joints of the arms and the hip, knee and ankle joints of the legs. The xi ravines are found attached to the joints in the rest of the body (Unschuld et al, Huang Di Nei Jing Su Wen vol 1 (1st ed), p 193).
I would like to hear about xi (valley) and gu (ravines).
Qi Bo says:
The large flesh gathers to assist the ravines. The small flesh assists the valleys, where the separations of the flesh [border or parting of the flesh], the valley and ravine meeting points are located; they circulate prosperously, building – it is a great gathering of qi. When evil qi overflows [from the luo] and obstructs, blood vessels heat up and the flesh fails to nourish, and the ying and wei qi will fail to move or circulate. Pus [phlegm] develops in the interior melting the bone and marrow, externally destroying the large fossa [e.g. of the knee]. It [evil qi] stays in the jié còu 節湊 [joints gathering] together, where the qi will certainly terminate [movement]. … Extreme cold settles in the ravines and valleys. The ravines and valleys are where the 365 acupuncture points assemble.
Su Wen 58.
There are many example points named after gu or xi, for example:
- SI5 yang gu Yang Valley
- KID 10 yin gu Yin Valley
- ST 43 xian gu Sunken Valley
- SP 7 lou gu Dripping Valley
- SP 18 tain xi Heavenly Stream
- ST 41 jie xi Stream Divide
- KID 3 tai xi Supreme Stream
Every tendon belongs to every joint.
Ling Shu 10
In the spaces between the muscles are the locations of many of the points and primary channel pathways. The ying and wei qi pass through these intersections. The wei qi passes via the muscles, tendons and joints. The ying qi flows through the primary channels. Therefore, these are locations of acupuncture points on the primary channel and where the ying qi circulates. The entering and exiting of qi in the joints are controlled by the liver and san jiao – these are the spaces in the joints.
The sinews are of the wood element. They weave, twist and bind like vines to a tree. Trees bear fruit and the tender areas often found at these binding areas are sometimes referred to as ‘fruit’ or ‘guo’.
The guo are ashi points or areas of tightness, nodules or some form of stagnation. The binding areas on all major joints are meeting points for multiple channels. Some binding areas cross over with multiple channel sinews, for example ST 12 que pen. Other branches bind into adjacent channels, like GB 34 yang ling quan.
When there is a pathology in a channel sinew, channels pull from a binding area, nodules, tightness or pain. The illustration of the bladder channel pathway connecting from the heel to the posterior knee highlights the binding areas with darker lines.
The importance of understanding jié 結 and the location of binding areas are fundamental for addressing channel sinew issues. When a patient has pain, palpate the channel and pay attention to the binding areas as this could be origin of the pain.
James qualified at City College of Acupuncture (CCA) in 2017 with a licentiate diploma at degree level and by 2019 completed a diploma in tui na. He has been teaching acupuncture and tui na at CCA since 2021.
Through a combination of experience and researching the classics and how they relate to modern anatomy, James uses palpation, acupuncture, moxibustion and tui na to address channel sinew pathologies. He is writing a book on channel sinews with an emphasis on breaking down the Ling Shu and the Nei Jing, channel pathways and pathologies.
All images © James Woodward
