This topic is one of the few but strong stumbling blocks which the western scientific mind confronts when approaching the theories underlying chinese acupuncture. Depending on the nature and the training background of each person, the reactions can vary from direct rejection to blind belief. That is why in acupuncture courses there is such a wide variety of opinions.
In the beginning, and although I had been trained as a western doctor, I accepted readily the very elegant and original idea emerging from the Chinese "medical" mind to explain the movements and activities inside the body. The logic of the circulation of action potentials along predominant and preferential pathways could only please the healing thinkers of more than 2000 years ago, and is still appealing nowadays. Without our scientific knowledge how could one explain otherwise the subtlety and flexibility of the human organism, and the daily and existential variations?
Well, yes, other medical systems have proposed different solutions, but this one is special: smart, complex, still existing nowadays, and as near as could be to the clinical reality.
Ah! I would have loved to retain this certainty of the first hours that I adopted without even questioning what these meridians could mean. But I did not expect the confrontation with science, with the patient, with the evolution of my thinking which slowly took place within the frame of analysis rigor and modern criticism. All the same I have fought for and defended this so attractive concept: I always try to save as many as possible of these old theories, setting them first in their historical and cultural context, then shedding light on them and explaining them (if possible) with the help of what we know currently of the human body.
It is true that no surgeon has ever found an acupuncture channel under his scalpel, not even something remotely alike. This phrase has for that matter become a cliché. But as real and correct as it is, the statement misses a certain reality of the body. And if it was born from the combined brains of a group of Chinese medical thinkers, it is because they had obviously observed something. The theory did not just descend from heaven by the merest of coincidences, but after repeated recordings of organic happenings. Some of these were in the shape of elongated forms, mostly in the sensitive field. For example, in body acupuncture, the pain of angina pectoris which often starts in the heart region and follows the inner side of the arm, ending in the last finger. Or the pain of a sciatic neuralgia which can start in the lumbar area and end in the toes. The patient himself draws sometimes on his own body a path of lengthy and narrow abnormal sensations. Finally some skin diseases manifest themselves along stretched bands of skin.
These band like experiences witnessed by the patients correspond with the paths of some meridians. At least part of them.
It is probably these phenomena, added to other observations (but I don't want to be exhaustive) which allowed the first practitioners to set up this concept of meridians, to enrich and structure it, then to generalize the concept. It is understandable that the idea cannot be accepted as such, but it would be unfair to simply reject it as a pure invention not related to anything.
It must be noted that in all the books or manuals of acupuncture published up to now in or out of China (well, there are a few exceptions...), the meridians are always explained in detail. And actually they are a good base for learning acupuncture techniques! Let's try to reconcile ourselves with these meridians (or channels). Regarding their pathway one could consider four categories or sections:
1. Part of the channel route overlaps the course of certain nerves.
2. Another part could be the projection on the outer area of the body of groups of neurons linked by preferential ties within the medulla.
3. A third group would be more like zones than linear paths or bands.
4. A last group wouldn't match with anything, probably the result of a not always controlled imagination.
This attempt to explain does not quite satisfy me but at least it has the merit of not throwing the concept in the trash can of crazy ideas. I would call it recuperation of what can be defended. We owe at least some respect to an impressively ancient healing method which has survived through the ages, like the culture in which it was born. This does not mean blind acceptance but enlightened scrutiny. Finally when students ask "how to do acupuncture" the concept of meridians is a very useful tool...
