Possible relationship of upper limb arteries, median and brachial to the twelfth meridian of the human upper limb

Abstract

Approximate location of the 12th meridian in the hand and the forearm in relation to median artery and median nerve.

Three hand yin meridians in ancient Chinese medicine were established initially based on arterial structures

“…I agree with the first concept proposed by Kumaratilake et al (2020) that vertical blood vessels represent meridians. This is further supported by descriptions from the silk meridian books unearthed from Mawangdui Han Tomb (221‐168 BC).…”

“…It was also stated in the silk books (Ma, 1980) that (1) pulses can be detected in yin meridians (no mention of yang meridians); (2) both hand yin meridians start from the heart and end at the wrists; (3) the pathology of hand yin meridians includes angina and necrosis of internal organs, and (4) patients suffering from acute illness of yin meridians (not yang meridians) may die quickly in days (heart attack?). In addition, the added 12 th meridian, Hand Jue Yin Meridian, in the middle line of the forearm, also starts at the pericardial vessel of the heart and correlates well with the persistent median artery (PMA) in the forearm (Kumaratilake et al, 2020; Li, 2020). The later appearance of the 12 th meridian or PMA was most likely due to the relatively low incidence of its presentation as an arterial variant.…”

“…The model of low resistance fluid channels as the system of meridians was primarily investigated in animals (Zhang et al, 2015) and its correlation with human meridians is less convincing anatomically. The connective tissue hypothesis (Langevin & Yandow, 2002) could explain local anatomy of certain acupoints and in some part meridians such as the connection between the wrist and third finger on Hand Jue Yin Meridian (Kumaratilake et al, 2020), but none of these hypotheses were aimed at explaining the 11 meridians prior to acupuncture era.…”

“…The second concept in Kumaratilake et al (2020) suggests that meridians are in connective tissue of intermuscular spaces. This represents one of several hypotheses that have been proposed recently to explain the structural basis of acupuncture meridians.…”