What is the role of the kidney channel in listhesis since the kidney channel goes to

the anterior of the spine? How do you treat listhesis including retro listhesis.

How do you approach and treat stenosis? Do you treat central and lateral stenosis
as the same?
Let us understand about kidney first.

Store the Jing and rule birth, growth, development, reproduction, and sexuality
Produce Marrow, fills up the Brain, and rule the Bones
Rule Water and Water Metabolism
Control inspiration and the grasping of Qi
Open into the Ears
Manifest in the head hair
Control the two lower orifices
Residence of the Zhi (Will Power)
Kidney Yin and Kidney Yang are the foundation of the Yin and Yang of the whole
body.
Kidney Yin and Kidney Yang rely on each other for their existence. Kidney Yin
provides material basis for Kidney Yang. Kidney Yang provides necessary Heat for all
Kidney function and organs with kidney yin

Back Pain

Q. Can back pain be cured by acupuncture, if used correctly?

A. If the underlying Chinese medicine 'syndrome' is dealt with properly, then the
pain goes or improves greatly.

Conversely, if the treatment fails to address the real reason, any improvement will
be temporary.

What does an acupuncturist think about when you say you have pain in your back?

Well - for instance:

What the pain is like

What makes it better or worse
The times or circumstances when it happens
How - if known - it originated
Are any strong emotions connected with it?
What happens elsewhere when you have it
How it affects you
On which acupuncture channel(s) the pain is felt
Where on those channels the pain is felt, and why.
The syndrome causing or accompanying the pain.
The 'Western' diagnosis will be considered.

Location of Back Pain

When examining someone with back pain, an acupuncturist thinks of the anatomy
and physiology in Western Medicine, but also of the energy (Qi) moving along the
acupuncture channels in the back.

Which acupuncture channels traverse the back?

Acupuncture Channels on the Back

The main meridian channels on the back are:

Governor Channel (spine)

Bladder channel
Gall-bladder channel
Small intestine channel (especially upper back and shoulders)
Three-heater (San Jiao) channel (upper back and shoulders)
Large Intestine channel (upper back and shoulders)
Kidney channel (spine)
Conception vessel (spine)
Chongmo (Penetrating) channel (spine)

Stomach tendon (or 'sinew') channel

Spleen tendon (or 'sinew') channel

Whenever we treat a disease, we must approach it at the base.' Base here means
root or source. Every stream on earth has a source, and every plant has a root. If all
murky sediments settle at the source, the downstream waters will naturally be clear
and fresh, and if we water a root, it will grow and branches will sprout; these are the
laws of nature. The experienced physician, therefore, will always consider the
source.

In relation to the other organ networks, the kidney is situated in the lowest position.
It is associated with the phase element water, and it is in charge of storing essence
(jing). Just like water was the first substance to emerge from heavenly oneness, the
kidney is the source of the human body, the initial sprout of physical life.

Everything between heaven and earth that is made from qi and blood has the urge
to mate. Once fire and water separate and desire finds a match, the essence leaves
the source, and what creates the body will turn into what kills the body. If you are a
student of the Book of Change (Yijing) and align your desires by fooling around with
the lofty hexagram 41 [Sacrifice, Decrease], then this is like being worried about
floods at one moment and about water leakage.

The kidney channel is the only one that originates on the sole of the foot. It runs to
the medial side of the leg, then along to the abdomen, where the channel is located
0.5 cun lacateral to the midline. In the thoracic area the distance from the midiline
is 2 cun. The channel ends
belowe the depression of the chavicle with point KI.27 Shufu. From the lower
abdomen the internal course course ramifies in the dorsal direction, courses along
the spine toward cranium, passes
through the kidney, then ascending through the liver and lung to the throat and
ending at the root of the tongue. From the kidney a further connection passes to the
urinary bladder, the coupled Yang organ. A further branch connects the starting the
startingt point KI. 1 Yongquan with the medial side of the little toe at the corner of
the nail. This branch connects with the urinary bladder
channel, which ends at the lateral nail corner of the little little finger
Details
The kidney meridian begins below the small toe, then comes across the foot to the
"heart of the sole" (near KI-1), then to KI-2, and up the leg along the kidney
meridian pathway. At the thigh it goes interior:

It passes up the spine, permeates the kidneys, and spirally wraps the bladder.

According to most sources the kidney meridian has a complex series of

trajectories. Once the meridian goes internal at the thigh, it passes to the spine at
GV-1, then up the spine (an indefinite distance), back down the spine and out to KI11. From KI-11 it superficially passes up to KI-16.

At KI-16 an internal trajectory circles backward between the skin and the
peritoneum, almost following the dai mai (girdle vessel) trajectory. The meridian
then enters and permeates the kidneys. Then, passing downward through the

ureter to the bladder, it spirally wraps the bladder. This path also passes out to CV3 and CV-4.

From KI-16 an external meridian passes up to KI-21. Here, another trajectory goes
internally to and through the liver and up through the diaphragm into the lungs.
There are two main interpretations of the trajectory after it reaches the lungs. The
first posits that from the lungs the meridian passes along the pulmonary vein to the
heart and spirally wraps the heart. It further travels to the "inside of the chest",
usually seen as CV-17. CV-17 is the reflex point of the "inside of the chest" and may
be a synonym for upper qi hai. A second interpretation proposes that the internal
trajectory ends at the lungs and that from KI-21 the external meridian passes up to
KI-25. From this point a trajectory passes inward to spirally wrap the heart and
reach to the "inside of the chest", CV-17..

From Sun Yikuei, Contemplations On Unexplored Medical Topics (Yizhi Xuyu), 1584:
In the Simple Questions (Suwen) section of the Neijing it is stated: 'The kidney
stores the qi of the bones and the marrow.' At another place it says: 'The black color
associated with the direction north corresponds directly with the kidney; its
corresponding orifices in the body are the two yin (the genitals and the anus), and
its essence is stored in the kidney.' The Nanjing (Classic of Difficulties) further
explains: 'This is where males store their essence.' This line does not mean that all
of the essence is stored right there; the brain is also called the sea of marrow, and
the kidney connects with the brain via the spine.
Master Shengsheng once said: 'Chapter 36 of the Nanjing states that there are
really two kidneys, namely the left one being the actual kidney, while the right one
is mingmen, the gate of life. It is this mingmen that is the seat of all physical (jing)
and mental (shen) essences, and it is here that essence is stored in males, and from
where the uterus branches off in females. Thus, we speak of two kidneys. Just as is
said in chapter 39 of the Nanjing: 'The fact that six fu organs are paired with five
zang organs means that the kidney really represents two organ systems, namely
the left one being the kidney, and the right one being mingmen. And mingmen, that
is the abode of jing and shen. This is where male essence is stored and where the
female uterus is attached; its qi is on the same wavelength with the kidney.''
A detailed examination of both sections of the Neijing does not yield any references
to a differentiation of the kidney network into two distinct parts. It was the author of
the Nanjing who first made this distinction. Does this mean that the entity which the
Nanjing author calls mingmen-the abode of jing and shen, the seat of the original qi,
the place where males store essence and females have their uterus-is nothing but
idle talk? I say we have to take this theory seriously, since it appropriately places

extra weight on the kidney network by emphasizing that the original qi which lodges
in the kidney is the source of our life force.
The Central Junction Classic (Huangting Jing) states: 'The kidney qi regulates the
upper burner, nourishes the middle burner, and protects the lower burner.' The
Collection of Central Harmony (Zhonghe Ji) states: 'Breathing through the process of
opening and closing-that is what happens at the gorge of mystery (mingmen), the
root of heaven and earth.' Opening and closing here does not refer to the regular
action of inhaling and exhaling through the nose or mouth, but to what is called the
true breath. The author of the Nanjing also said: 'The igniting spark between the
kidneys (shenjian dongqi) is the origin of the various processes of human life, the
base of the body's five zang and six fu organs, the root of the twelve channel
pathways, the door of breath, and the source of the triple burner.'
Precisely this is what the concept of mingmen is all about. It is what the Confucians
refer to with their Taiji image, and what the Taoists call the gorge of mysterious
origination. If we take a close look at a bronze acupuncture statue we can easily find
out that the point mingmen is not located on top of the right kidney, but right
between both kidneys. This certainly proves my point.
From Chen Shiduo, A Secret Manual from the Stone Chamber (Shishi Milu), ca. 1690:
As has already laid out in detail in the Nanjing, mingmen is the master of the twelve
channel networks. But even though many texts have since been written about this
subject, the quintessence of mingmen still remains in the dark. Therefore I chose to
bring up this topic one more time.
It is always said that mingmen is the master of the twelve channel networks. Now,
what kind of master is it exactly and what does it master? Let me put it this way: if
there is no fire inside us, we cannot exist. This fire must be there first so that the
twelve channel networks can be imbued with the igniting spark of transformation.
mingmen, therefore, is a type of prenatal fire. This fire is immaterial and dwells in
water. On earth, material fire is being quenched by water. Immaterial water, on the
contrary, has the ability to generate fire. Therefore, when we say that "fire is being
quenched by water" we refer to material water; when we say that "fire is being
fueled by water" we refer to immaterial water. And it so happens that immaterial
fire can generate immaterial water, meaning that fire is not contained within fire,
but within water.
Mingmen fire, is yang fire-a yang that is embedded within two yin. In the
microcosmic context of the human body, mingmen is generated first, and only then
the heart. Does this fact not illuminate the importance of mingmen? When the heart
procures the power of mingmen, consciousness is in command, and we can relate to
the outside world. When the liver procures the power of mingmen, it can plan. When
the gallbladder procures the power of mingmen, it can make decisions. When the
stomach procures the power of mingmen, it can absorb food. When the spleen

procures the power of mingmen, it can transport. When the lung procures the power
of mingmen, it can fulfill its administrating and regulating functions. When the large
intestine procures the power of mingmen, it can pass on the waste. When the small
intestine procures the power of mingmen, it can disseminate. When the kidney
procures the power of mingmen, it can bring about physical vigor. When the triple
burner procures the power of mingmen, it can keep the body's water pathways
unobstructed. When the bladder procures the power of mingmen, it can store. In
other words, there is not a single one among the organ networks that does not rely
on the mingmen fire for warmth and nourishment.
This type of fire should be tonified rather than purged. This is done by tonifying fire
within water, and especially by tonifying water within fire. In this fashion, fire can be
fueled by water and at the same time be stored within water. If we just use cold or
cool herbs to attack the mingmen fire, it will become weak, and how could it then
nourish the twelve channel networks? This is what is really meant by the Neijing
statement 'when the master is dim, the twelve officials are all in a state of crisis.
Western ideas
Orthopedics is practiced very differently practised with TCM . A lot of this theory is
based on Matt Callisons work which is based on the tendino muscular channels.

As already shared, the pathway of the kidney channel trascends the lumbar spine.

In listhesis the pars interarticularis is either not developed or has weakened due to
arthritis. This caused the vertebrae to slip. This presents itself as an anterior
movement of the superior vertebrae over the inferior one. Usually seen at the L5 S1
region. Or any part of the vertebra bringing anatomical changes both in the disc and
vertebra

There are different grades to listhesis. Grade 1 2 3 4. All correspond to the

percentage of slippage. Usually grade 1 is what we treat.

So how do we go about it?

Most patients showing listhesis will have an increased anterior tilt of the pelvis. This
is accompanied by a tight quadratus lumborum muscle and a tight psoas and
illiacus.

Surprisingly, if one follows the internal pathway of the KI channel one will see that it
mimics the psoas muscle once it reaches that area.

Before treatment you always evaluate the patient. If there is severe radiculopathy,
loss of balance, waddling gait and muscle weakness like a foot drop you may want
to refer out urgently. Listhesis can have a component of stenosis and if yes this can
be very difficult to treat.

Basically for listhesis one corrects the discrepancy between the anterior and
posterior surface of the body.

GB29 and GB27 are close to the motor points of the TFL and the illiacus psoas. By
needling them you help relax the muscles that are causing force on the anterior
region. Moxa helps tremendously.

Once the patient feels better we work on the quadratus lumborum which uses
approx UB52 as it's motor point. This releases the QL spasm. By correcting the
muscle imbalance you release the strain on the lumbar spine. This itself brings
great relief to the patient.

There are tendino muscular channels as well. There are knotting points roughly
around Liv 4 and GB 39. By needling these knotting points one is also able to help
reduce the anterior tilt.

Post that continue with normal protocols of any system one is well accustomed too
and treat it as if it is sciatica.

Eventually you have to strengthen the abdomen and gluteus maximus as this will
prevent future relapses.

Listhesis can also contribute to stenosis which can make it tricky to work on.

There are two types of stenosis. Central canal which can be caused due to listhesis,
disc herniation or ligamentum flavum hypertrophy. Then there is foraminal stenosis
which is tricky.

Degeneration in the disc will be followed in the future lecture . With tcm