(An Analysis Using the Scholarly Insights of Dr. Elisabeth Rochat and Master Kiiko Matsumoto, LAc.)
Chariots were a key means of transport and strategic attack for the military of ancient China. Chariots are fast, light and open two-wheeled structures, often pulled by several horses. As a unique two wheeled vehicle with very specific kinetics and cultural significance, it is only fitting that the ancient medical doctors would imbed the imagery of a chariot into applicable acupuncture points on the human body. Four pairs of points have this character, che 車 (vehicle or chariot) in their name; interestingly three of the four are on the lateral line of the body and they are located in places that function in some way as axes for pivoting the human frame.
A chariot requires strong straps or reigns to attach the cart to the horses. In a comparison to the body, this could be thought of as the lateral sinews holding distal structures together, such as the legs to torso and torso to head. Our central point of interest in this paper, GB 23 辄筋 zhe jin, is often translated as “Flank Sinew” or “Sinew Seat,” and lies on the lateral line of the body, approximately 3 cun below the axillary crease in the 4th or 5th ICS (depending on the source), 1 cun anterior to GB-22. This character zhe 辄 has within it the character che 車 for chariot, which itself has a graphic resemblance to the skeleton and wheel axles of a cart. In Grasping the Wind, it is described as “The side of the chariot just above the wheels.” (2) Conventionally, as in Peter Deadman’s A Manual of Acupuncture, the point is known as an alternate Gallbladder Mu point, to influence and regulate qi, the diaphragm, chest fullness, asthma, and rebellious qi such as heartburn or vomiting, as well as a place to help release unexpressed anger, frustration and resentment that may be stored in the chest. (1)
In the Japanese tradition, GB-23 has been more specifically translated, zhe 辄 as Chariot 車 (or Wheel) in the Ear 耳, and jin 筋 as “Sinew,” so altogether we might call this “the sinew to the chariot/wheel in the ear.” Extrapolating from the analysis of Master Matsumoto and other Japanese Masters such as Master Kuzome and Master Nagano, we could interpret the lateral line of the shao yang zone along the rib cage as a sinew relating to the ear above. This sinew could have its functional analogy in the reigns that connect the chariot cart to the horses. The Chinese may have known, as well, that when the skull was split open, the cochlea would appear as a kind of wheel in the inner ear.
This original insight connecting GB-23 to the ear in ancient China, when naming the point, might have been derived from clinical experience, deep intuitive insight or other methods which we are not aware of in modern practice. However, it is fascinating to compare the implication of the name zhe jin with modern evolutionary insights from ichthyology. Fish have a lateral line of hair cells that can sense vibration in the environment. This lateral line stretches along what we would call the majority of their shao yang zone. (3) The function of these cells is similar to the function of the hair cells in the human ear. There might be an evolutionary echo or memory of this structural physiology in the modern human which retains the lateral line’s ability to have a direct impact on the inner ear and the motion sensing hair cells therein. (3) I have had the opportunity to see Master Matsumoto treat several patients for tinnitus with the GB 23 point (in combination with other points such as Liver 13, another lateral line point), with immediate success in changing the pitch and reducing the volume of the tinnitus. In the Kiiko Matsumoto Style and Japanese lineage, GB23 can be an important indicator and treatment point for dizziness as well, which we know in modern physiology can relate to the inner ear. In a metaphor to the point’s name, the spinning motion felt during dizziness could reflect how a chariot will spin and capsize if one wheel/axle falls off the cart.
Renowned scholar of Chinese medicine, Dr. Elisabeth Rochat, points out GB 23 is also known as the meeting point of the GB and BL channels, so at this point we have a connection on a wood channel to the water element as well, which may further be involved in this point’s ability to regulate and nourish the ears, which belong to the kidneys and foundation of the body in Chinese medicine.
Dr. Rochat and Matsumoto made the connection that we indeed have several other points along the lateral line embedded with the chariot character: St-6 頰車 jia che, Jaw Chariot, and GB-38 陽輔 yang fu - “Yang Assistance.” Another point St-14 ku fang, “Armoury (or Granary) Storeroom,” has the chariot character 車 as well, located on the upper breast 4 cun lateral to midline, at the level of the 1st ICS. However, this character is housed under the character for a room, and together may suggest the place where chariots are stored such as the armoury. It has also been interpreted as a granary or general storeroom since it is on the foot yang ming channel connecting to the stomach organ, a storehouse of our food. The St-14 area on the chest is a place that feels most pronounced when one has good posture and sticks out their chest. It may be a place where the ascending Gu Qi from the stomach interacts with the Zong Qi in the chest, as a repository or qi reserve in this energetic mechanism. The question remains open how precisely, or if at all, the various chariot points interrelate, yet the fact that they are all on the ST and GB channels and that the three of them are distributed evenly on the lateral line spanning the entire body seems to hint that there is more than coincidence to their naming. St-14 may perhaps influence the ability of the body to distribute the qi to the lateral sinews and shao yang channels, a kind of a central storage hub for the chariot of the lateral line, and a potential treatment to strengthen structural prolapse in the body. Interestingly, St-13 is used for this purpose in the Japanese tradition. I have had success using ST-14 in the clinic for tinnitus and TMJ with jaw tightness showing up at ST-6. The best way to needle this point to release the ear and jaw is in an upward direction subcutaneous, similar to how St-13 is needled to help with prolapse due to a weak stomach meridian.
These 4 sets of “Chariot Points” are all on the stomach and gallbladder channels. The significance of this could be that these meridians have particularly important structural functions, for example they are two of the three channels which in their external pathways stretch from the head to the foot. Moreover, the gallbladder foot shao yang channel holds together the edges of the body, and the stomach foot yang ming channel functions as the sole yang meridian on the anterior surface of the body, which provides a critical structural function to uphold the body’s yin aspect.
ST-6, GB-23 and GB38 all appear to be areas on the lateral zone that have a natural tightness to them, perhaps due to their structural function as pivot points of lateral motion in the body, but as areas which are also susceptible to become too tight and hold structural tension. When one thinks of a cart or a chariot that is starting to break down, one of the first things that comes to mind is the change in sound that the chariot would make. One would start to hear the wheels squeaking, or the axels grinding. In the body these symptoms may reflect tinnitus, relating to the inner ear and reflecting at GB-23, or a tooth grinding (often at night), reflecting at St-6. St-6 has the alternate name “Ghost Bed” and is one of Sun Si Miao’s Ghost Points. This may relate to the grinding that comes out at night when someone is unconscious and unrecognized tension needs to find a physical outlet. St-6 頰車 jia che - “Jaw Bone” or “Jaw Chariot,” the 7th Ghost point, is located at the prominence of the masseter muscle when the jaw is clenched. According to Grasping the Wind, the jaw is sometimes referred to as the tooth vehicle (ya che). Indeed, the Jaw via the temporomandibular joint has mobility in 360 degrees, and this mobility, as Dr. Rochat points out, can be compared to the way a chariot can go forward as well as turn in a rounded way to the side. As a Sun Si Miao Ghost point with alternate names such as gui chuang “Ghost Bed” and gui lin “Ghost Forest,” it may have been used for conditions such as epilepsy and mania. It could be pertinent that a symptom of someone with stress can often be gnashing their teeth at night, as if a ghost or unexamined part of the psyche is making itself known and trying to digest something. Moreover, this teeth grinding at night could be considered another sound of the “human cart” becoming unhinged, imbalanced or too tight. This point may relate to spiritual matters which are difficult for the earth element to digest, and so the inner tension is siphoned to the lateral aspect of the body. Many of the conditions which are listed for St-6 often relate to local issues of wind, such as Bell's Palsy (Peter Deadman’s A Manual of Acupuncture). A chariot, like qi, must be able to move smoothly to perform its duties, and an imbalance between various parts of the body could lead to the inhibited flow of qi.
Finally, we have GB-38 陽輔 yang fu - “Yang Assistance,” a Jing-River and fire point
4 cun above the prominence of the lateral malleolus, at the anterior border of the fibula. As a distal point and one of the 5 transporting points of the foot shao yang channel, GB-38 may have the most systemic influences of all the chariot points. In Grasping the Wind yang fu is translated as a “pole attached to a cart to keep it from upsetting.” This translation may refer most directly to an influence on the assisting function that the fibula plays in relation to the larger more central tibia bone. (6) According to Deadman, GB-38 can clear heat and harmonize the shao yang zone, relieve temporal headache, pain and qi stasis in the chest or lateral costal region, and treat shao yang conditions like malaria with alternating chills and fever, wandering bi syndrome, and weakness in the lumbar region. In the Japanese Kiiko Matsumoto lineage, GB-38 is used to release pain at the SCM muscle or spine, including issues of spinal injury. It was also used by Master Nagano for Bell’s Palsy, which provides an interesting connection to our discussion of St-6 above. Pressure pain at GB-38, a fire point, would indicate heat in the channel and often be treated with the metal/water points, GB-43 and GB-44.
Gb-38’s name indicates that it has a structural component, “the pole attached to a cart,” perhaps to stabilize the ascending yang qi and thereby stabilize the rest of the human chariot. Heat in the body may show up as pain at this point, similar to axles on a cart generating friction. Perhaps treating this point can relieve some of this structural stress and the heat that comes with it. Further investigation, both clinical, theoretical and historical is needed to understand these points and their applications, and to explore how the various chariot points can be used in concert. It may be fruitful to cross-reference their usage in various traditions. Nevertheless, it is fascinating how, along the lateral line, we have one set of chariot points for the lower limbs, one for the thorax, and one for the head, together to form a complete structure of the human form.
References.
Deadman, Peter, et al. A Manual of Acupuncture, 2nd Edition, Journal of Chinese Medicine Publications, 2007.
Ellis, Andrew, et al. Grasping the Wind: An Exploration into the Meaning of Chinese Acupuncture Point Names, Paradigm Publications, 2012.
Matsumoto, Kiiko et, al. Kiiko Matsumoto’s Clinical Strategies: In the Spirit of Master Nagano, Volume 1, 7th Edition, J&R Graphics, 2017.
Matsumoto, Kiiko et, al. Kiiko Matsumoto’s Clinical Strategies: In the Spirit of Master Nagano, Volume 2, 2nd Edition, J&R Graphics, 2012.
Poulin, Erika. Traditional Chinese Medicine Curriculum Review, 2017.
Lectures from Elisabeth de Rochat, Winter, 2020.
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