4/3/2015 M-Test (Meridian-Test)

M-Test (Meridian Test) e-Mail Japanese

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This thesis was carried with the permission of NAJOM.

M-Test The Meridian Test: Acupuncture Treatment Based on Assessment of

M-Test Movement
Mukaino Yoshito
Procedure

NAJOM
1. Introduction
The meridians and acupuncture points discovered by our ancestors have been described as a
Topics primitive signal transmission system by Manaka Yoshio M. D.1 The primary components of this
system are distributed over the whole body like a transportation network. The meridians can be
compared to railway lines, and the points to stations. Their organization is similar to railway
Blog networks, and the pathways are complex and densely interwoven. Even though a person may
not be aware of abnormalities in this network, it can produce various symptoms. It is probable
that early detection and daily correction of abnormalities could play an important part in the
maintenance of our health as well as successful treatment. Most of the methods devised and
employed up until now to detect these abnormalities, however, are not so easy to master.

I have treated many college athletes using acupuncture and moxibustion at my clinic next to the
gym since 1989 when I was transferred to the Department of Sports and Health Science from
the School of Medicine. In 1992 I had a sudden inspiration and created a method for identifying
the abnormalities that needed treatment. It is a method of assessment based on finding the
movements that cause or aggravate pain. With this method the meridians and points to be
treated can be decided quickly and precisely. It is also useful as a measure of treatment
outcome, and it is possible to monitor the continuously changing pathological condition. I have
used this method for various conditions other than musculoskeletal problems at the University
Hospital where I also worked. Thus I have confirmed that this method can serve as a standard
modality. I named this method the Meridian Test 2,3,4 (weve been calling it the M test since
2007) and have used it extensively in my clinical practice. It is a simple method that elucidates
the abnormalities in meridians and points in terms of a series of physical movements. Anyone
can learn to use the Meridian Test because it is easy to understand and it can serve as a
valuable first step for treating pain and maintaining health.

2. Meridians and points and the movements related to the occurrence or exacerbation of
pain
I will explain how the meridians or signal transmission system is involved in movement by
using the example of shoulder pain that occurs in a volleyball player during a spike (Fig. 1). In
the case of this shoulder pain (B), no abnormality could be found in the shoulder itself, and the
cause of pain was a mystery. However the player had taken a fall blocking a spike several days
before that and had slightly injured his knee and ankle (A). He wasnt aware of any pain in the
injured areas, but marked tenderness was noted. Needling the shoulder area (B) had no effect
whatsoever, but needling the injured area (A) instantly eliminated the pain during the spiking
motion. As shown in the figure, the meridian that goes through the injured area runs up the
lateral aspect of the thigh to the lateral thoracic region, and goes up around the shoulder to the
side of the head.

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In the above case, the injury in the lower leg (especially around GB-40 and GB-34) triggered an
imbalance in movements of areas along the course of the same meridian. The pathological
mechanism can be understood as the added strain of the spiking on the shoulder serving as the
exciting cause of pain. Aside from cases of sports injury like this, the same mechanism applies
to pain and symptoms that come from movements in daily life. The pathological mechanism of
meridian imbalances causing restrictions and pain in movement in other parts also applies to
symptoms that cannot be explained by modern medicine.

Figure 2 shows a case where low back pain did not resolve for a long time even after the patient
received laser surgery for a herniated disk. As shown in the figure, the Patricks test on the right
and posterior flexion exacerbated the back pain. The abnormal meridians can be identified just
from these two findings, and giving acupuncture to the corresponding points cured the back
pain.

Some practitioners tend to think that this approach is useful only for musculoskeletal problems
because the diagnosis and treatment is based on movements of the body. It is my experience,
however, that imbalances in physical movements are often associated with diseases other than
musculoskeletal problems. Figure 3 shows the case of a 65-year-old man who continued to
experience burning pain during urination and nocturnal polyuria after three laparoscopic
surgeries for prostatic hypertrophy. The Patricks test on the left side was positive for this
patient, and needling points on the meridians associated with this movement alleviated the
symptoms in just two treatments.

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In this way, the chain reaction of abnormalities in movement is related to the occurrence of
symptoms. Giving treatment based on my premise that imbalances in movement are associated
with the improvement or exacerbation of pre-existing conditions allows more effective treatment
of cases that dont respond to medical treatment or those in which the effect was limited.

3. How to work with the relationship between movement, meridians, and points
Looking the 12 regular meridians, the pathways and their points basically consist of three
groups that are located on the anterior, posterior, and lateral aspects respectively. Each of
these aspects can be divided into superior and inferior halves, so basically there are six sectors.
By designating movements that stretch the meridians and points in each of these sectors, we
can identify the meridians and points that are abnormal. In this way we can detect abnormalities
that the patient is not aware of. Figure 4 shows the sequence of movements for the Meridian
Test. Only the movements to the right are shown in this chart, but movements in both directions
are shown in the table for Meridian Test findings (Fig. 5). One can quickly determine which
sector has the problem by noting reactions of pain, tightness, fatigue, or other abnormal
sensations with each movement. We also consider it a positive finding when the movement
causes dizziness or shaking, or we note a difference between the right and left sides in range of
motion or resistance to movement. The findings are each rated on a scale of 1 to 10, and
treatment of the findings with the highest score takes precedence. Often the various minor
findings naturally resolve when the most significant findings are treated.

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The numbers below the movements indicate the order in which the movements are performed.
There are several variations to the neck movements 1 to 3, and these variations are performed
where appropriate. The movements of the legs 16 and 17 are done in sequence, and its most
efficient to have the patient to turn over and lie supine to perform movements 18 through 22.
Even when the Meridian Test movements are done carefully to confirm abnormal findings, they
can be completed in about 10 minutes.

4. All Meridian Test movements are combinations of basic movements that stretch the
meridians and points
Figure 6 shows the Meridian Test Findings Chart on the right and a baseball pitcher winding up
on the left. Observing the movement of individual joints we find that they each correspond to
one of the Meridian Test movements. This applies not only to baseball but other sports and
movements in daily life. In other words, the movements that we make can be called a
combination of basic movements that stretch the meridians. A movement that is repeated over
and over generates fatigue in the aspect that is stretched, and in all probability this influences
the linked movements in the same meridian group. It follows that the occurrence of pain and
decline in performance among athletes, as well as the exacerbation and amelioration of various
symptoms and diseases of working people are most likely under the influence of imbalances in
movement linked by the meridians.

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5. A different parameter for assessing disease

We obtain a different parameter for assessing disease when the meridians and points are
examined through movements. I will explain how this works by presenting three cases I treated
one fall (see Fig. 7). The patients symptoms were shoulder pain, dizziness, and numbness
around the elbow from peeling chestnuts. The main Western medical tests performed in each of
the cases are listed in the figure. In each case the movements aggravating the pain, which were
identified by the Meridian Test, were those that stretched the Lung and Large Intestine
meridians (see Fig. 8). Since these findings represented abnormalities of the same meridians,
the same treatment principle was used. In each case the symptoms resolved with one or two
treatments.

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To peel chestnuts with a knife, one uses the thumb and index finger the most. Repeating this
action over and over caused abnormalities in movement along the Lung and Large Intestine
meridians, which terminate in the thumb and index finger. This is what caused the various
symptoms in these three cases. The influence on the same meridians differed due to
differences in the patients bodies and the ways in which they peeled the chestnuts. This is no
doubt what led to the manifestation of different symptoms. Checking a series of movements that
stretch the meridians in order to examine a patient gives us a different parameter with which to
assess diseases and symptoms.

6. Locating effective points

In my treatments utilizing the Meridian Test I use a variety of points including distal points on the
arms and legs (e.g. Luo Connecting, Xi Cleft, Five Phases points), as well as points in large
muscle groups, and those on the torso like Front Mu and Back Shu points. I also use points on
the spine and in the pelvis as well as auricular points. The effective points among these must be
located. The points associated with the meridian judged to be abnormal by the problematic
movements are pressed lightly with a finger as the same movement causing the pain is
repeated. For example, when the movement that causes the greatest pain is dorsiflexion of the
ankle, as shown in Fig. 9, points of the Kidney and Bladder meridians that are stretched by this
movement become the focus of treatment. So points on these meridians are pressed one after
another as the same movement is repeated. When pain or other symptoms (e.g. range of
motion) is markedly improved with the application of finger pressure, the point is judged to be
effective. It is fine for the points tested in this manner to be based on the practitioners
experience, but we generally use the following order in testing points.

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First we use the Five Phases points, and if this doesnt resolve the problem we use Luo
Connecting and Xi Cleft points. Then we try points in large muscle groups of the upper arms or
thighs, and then points on the torso like Front Mu and Back Shu points. Finally we try cranial
points, and points in the spine and pelvic area as well as auricular points. In order to increase
the effect we may use a combination of these points. We also use Yin-Yang crossover point
combinations (see below) as much as possible. The point location and combinations vary by the
condition treated, but the Five Phases points are most useful in terms of understanding the
effect.

7. Application of Five Phases points to correct abnormalities in movement

The Five Phases point selection based on chapter 69 of the Classic of Difficulties (Nanjing) 5, 6
uses a total of 24 points, two points each from each of the 12 meridians (see Table 1).
Sometimes a combination other than these 24 points is used to increase the effect. I will explain
the characteristics of these points by discussing case histories.

TABLE1 Five Pheses point combinations used in

Meridian Test
Yin Meridians
Wood & Fire LV-2 HT-9 & PC-9
Fire & Earth HT-7 & PC-7 SP-2

Earth & Metal SP-5 LU-9

Metal & Water LU-5 KI-7
Water & Wood KI-1 LR-8
Yang Meridians
Wood & Fire GB-38 SI-3 & TB-3
Fire & Earth SI-8 & TB-10 ST-41
Earth & Metal ST-45 LI-11
Metal & Water LI-2 BL-67
Water & Wood BL-65 GB-43

Figure 10 shows the case of a 59-year-old Belgian man who had pain in both shoulders for over
a year. This pain was not relieved no matter how many places he received treatment, and the
cause of the pain was unknown. Lateral rotation of the arm in a horizontal position aggravated
the pain, and in this case PC-9, PC-7, TB-3 and TB-10 were candidates for treatment. I had to
determine the most effective point among these, so I had the patient repeat the movement that
aggravated the pain as I lightly pressed a point with a finger. I repeated this on the other three
points to find out which one relieved the pain the most. For this patient PC-7 and TB-10 (the
points circled in the figure) reduced the pain aggravation. These are points on the Pericardium
and Triple Burner meridians of the arm. After treating these points, I also stimulated the Five
Phases combination points on the Spleen (SP-2) and Stomach (ST-41) meridians of the leg.
This immediately relieved the shoulder pain. I asked the patient, By the way, what have you
been doing everyday? He told me he had been doing 50 pushups everyday from a year ago.

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The points I treated were in areas that are stressed by pushups (see Fig. 11). From a Five
Phases perspective, it can be understood as points that correspond to the relationship of the
lateral aspect of the arm (Fire) and the anterior leg (Earth).

Examining the effect of Five Phases point combinations on various patients, often the
stimulation of points that are located in areas stressed by movements that aggravate the pain is
most effective. The insight possessed by the ancient acupuncturists is astounding. By applying
the wisdom of the ancients, we can gain detailed information about the mutual relationship of
movements in the arms and legs as well as its relationship to disease in individual cases. I
believe this perspective opens a new path for treating diseases and improving and maintaining
health.

8. What can be achieved by improving abnormal movements?

Figure 12 shows the improvement in a pitchers performance through acupuncture after
abnormal Meridian Test movements have been identified, even though he was not aware of any
problems. Pitchers repeat the same movement over and over, and fatigue accumulates in one
area in the chain of movement as the number of pitches increases. This probably affects the
entire chain of movement and decreases performance. By improving the abnormal Meridian
Test movements with acupuncture, the pitching speed consistently increased. Myograms of the
shoulder - area muscles used during a pitch showed little change in the case of the deltoid,
trapezius, and the pectoralis major, but the electrical discharge of the biceps and triceps was
notably reduced. It is assumed that the reduced load on the biceps and triceps as well as the

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increase in pitching speed occurred because the acupuncture produced smoother and more
efficient movement.

Stiffness in the neck and shoulders, which many people experience, produce abnormalities in
movements, especially of the neck. We studied the activity of the autonomic nervous system by
comparing people treated for neck and shoulder stiffness and those with untreated neck and
shoulder stiffness. For this study the heart rate variability of the subjects seated for 30 minutes
in a chair was recorded. The sympathetic nerves remained activated (higher heart rate) for
subjects with untreated neck and shoulder stiffness (Fig. 13). The subjects that were treated did
not have sympathetic nerve activation, but instead their parasympathetic nerves associated with
relaxation were active.

With many diseases, the excitation of the sympathetic nerves (which become active in stressful
situations) becomes the exciting cause. Therefore regular acupuncture treatments to reduce
tension and make physical movements smooth could be an effective way of achieving the
ancient ideal of treating diseases before they manifest. Often the occurrence and aggravation of
symptoms like pain are associated with abnormalities in movement. Such abnormalities often
go unnoticed by the patient, but information for rendering treatment with instantaneous results
can be obtained when we examine these abnormal movements from the perspective of the
signal transmission system of meridians and points. This approach is not limited to
management of symptoms caused by fatigue from daily or repetitive movements, but extends to
symptoms and structural problems where the cause is unclear. We can detect problems in the
early stage in the signal transmission system of meridians by finding abnormalities in
movement. I believe that this approach of regularly treating such abnormalities will provide a

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valuable first step in the treatment of disease and health maintenance.

NOTE: Yin-Yang crossover point combination is the use of points on the opposite meridian in a
Yin-Yang and Five Phases relationship. For example, if the Lung meridian on the left is
indicated by the Meridian Test, then points on the Stomach or Bladder meridian on the right are
also treated. Therefore, when LU-5 on the right is judged to be the effective point, BL-67 on the
right can also be treated.

References
1. Manaka Yoshio with Itaya Kazuko & Stephen Birch, Chasing the Dragons Tail,
Paradigm Publications, 1995.
2. Mukaino Yoshito, et. al., The Meridian Test: A new method of defining effective
meridians for the treatment of painful disorders of the neck by acupuncture
Proceedings of the FISU/SESU conference, the 18th Universiade in Fukuoka,
1995, p. 498-499.
3. Mukaino Yoshito, et. al., Keiraku Tesuto (Meridian Test), Ishiyaku Shuppan,
Tokyo, 1999.
4. Mukaino Yoshito, Keiraku Tesuto-ni-yoru Shindan-to Hari Chiryo (Diagnosis
and Treatment Using the Meridian Test), Ishiyaku Shuppan, Tokyo, 2002.
5. Shudo Denmei, Introduction to Meridian Therapy, Eastland Press, 1983.
6. Kosoto Takeo & Hamada Toshiyuki, Ishaku Hachijyu Ichi Nangyo
(Commentaries on the 81 Difficuties), Tsukiji Shoten, Tokyo 1974.
Mukaino Yoshito M. D. was born in 1947 and was licensed as a medical doctor in Japan in
1971. In 1979, he studied acupuncture for 3 months at the Shanghai Zhong-yi College. He
became a professor in the Sports Science Department at Fukuoka University in Japan. He also
studiedPathophysiology for a year in Gettingen, Germany and EBM for a year in Exeter, Great
Britain. He is Chairman of the National Licensing Committee for Acupuncture in Japan.

Copyright Yoshito Mukaino. All Rights Reserved.

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