The Divergent Meridians: How Neurology Illuminates a Classic Framework

The Divergent Meridians and Autonomic Imbalance

The divergent meridians occupy an esoteric and enigmatic position within classical Chinese medicine. They appear in the historical record earlier than the eight extraordinary vessels, yet their purpose and use remain shrouded in mystery. Unlike the primary meridians or the Eight Extraordinary Meridians, which have more defined functions and methods, the divergent meridians have no clear consensus on their clinical use. Many modern practitioners never use them.

Divergent meridian pathologies are used for cyclical or reflexive patterns of imbalance. These include conditions that are seasonal, time-dependent, or triggered intermittently, reflecting an inability of the body to fully resolve pathology at a deep level. Recurring injuries, allergies, and autoimmunity have been said to indicate divergent meridian dysfunction. Because they extend deeper than the primary channels and penetrate the Zang-Fu organs, they were used for chronic and latent conditions that could not be addressed solely through the primary channels.

Dr. Royston Low, in The Secondary Vessels of Acupuncture, describes the divergent meridians as a bridge between the body's superficial defenses and deeper physiological systems. Their function of linking the defensive energy in the more superficial layers of the fascia with the interior parallels autonomic processes supported by the vagus nerve, sympathetic activation, and parasympathetic restoration. The fact that many divergent meridians pass through the heart suggests a relationship with the fire-water balance (Heart-Kidney axis), which mirrors the HPA axis in mediating defense responses.

This integration of classical and modern perspectives provides a framework for exploring how the divergent meridians may be used to help restore autonomic balance. By engaging these pathways, we can address both physical stagnation in the sinews and the deeper autonomic and emotional patterns that perpetuate chronic illness.

Historical Perspective: The Origins and Evolution of the Divergent Meridians

The Ling Shu is a foundational texts of Chinese medicine, and was compiled over hundreds of years, reflecting the perspectives of multiple practitioners. The earliest sections likely originated during the Warring States period (475–221 BCE) and the Han Dynasty (206 BCE–220 CE), but the version studied today was finalized around 1120 CE as part of the Song Dynasty’s efforts to preserve medical knowledge.  The divergent meridians first appear in Chapter 11 and are described as a network that links the external (fascia) and internal environments (viscera) of the body. Circulating defensive energy (wei qi), they are said to prevent external pathogens from entering the yin viscera, allowing the body to process latent conditions.

Because their classical function is not clearly outlined in other texts, the role of the Divergent Meridians has been subject to varied interpretations. A review of historical sources reveals significant discrepancies in how these channels are illustrated and described, with differences often shaped by the texts referenced, clinical experience, and personal lineage of the practitioner. This variability raises an important consideration: if the Divergent Meridians primarily serve as pathways for unresolved physiological patterns, their expression may not be fixed but instead shift in response to autonomic function, neurology, and fascial tensions—factors that classical texts could not fully account for. 

Dr. Royston Low called them "separate master meridians" because they seem to function independently of the primary and extraordinary vessels while overlapping in certain areas. Scholar Jeffrey Yuen suggests that these channels represent the body's ability to adapt to external changes, facilitating a harmonious interaction between innate constitution and the surrounding environment. Miki Shima, alongside co-author Chip Chace, describes the divergents as distinct pathways that influence the distribution of qi, blood, yin, and yang. While classical texts do not assign unique acupuncture points to the divergent system, Shima identifies specific confluence points where each pair converges. These points, however, are borrowed from the primary meridians rather than exclusive to the divergent channels.

Jake Fratkin, OMD, has extensively documented the Divergent Meridians, providing some of the most articulate descriptions of their function and significance. His work builds upon previous research, particularly expanding on Miki Shima’s contributions, and presents a comprehensive structural overview of these enigmatic pathways.

Classical Characteristics: Pairing and Organization

The twelve divergent meridians correspond to the twelve primary meridians and are grouped into six yin-yang pairs, referred to as the six Confluences in later classifications.

• Yang divergent meridians penetrate their associated Zang organs before reconnecting with their primary meridian, reinforcing the role of Yang channels in deep physiological regulation.
• Yin divergent meridians do not return to their own primary meridian but instead merge with their paired Yang counterpart, linking internal organ function to the circulation of Wei Qi (defensive).
• They hold latency—classical texts describe them as storing unresolved pathogenic factors, which aligns with how recurring infections and chronic inflammatory conditions reemerge. Hepatitis and herpes are prime examples.
• They have a strong connection to joints and deep organ systems.

 

Pathway and Function

• Divergent meridians separate from their primary channels at major joints, particularly the knees, hips, shoulders, and elbows, reinforcing their role in chronic joint conditions and systemic transitions.
• They ascend toward the torso and converge in the neck, supraclavicular fossa, or face, influencing sensory processing, brain function, and the integration of external stimuli with internal physiology.
• Yang Divergent meridians enter their associated Zang organ before reconverging with their primary Yang channel in the upper body, reflecting their role in transporting Wei Qi inward.
• Most Divergent meridians pass through the Heart, reflecting a visceral pathway and a more external sinew trajectory. 
• Classical texts emphasize their role in ‘buffering’ external pathogens that have not fully penetrated the body but are also not entirely expelled, placing them at the crossroads of acute and chronic disease processes.

Reconvergence points:

• Bladder Divergent → Rejoins at UB10 (neck)
• Gallbladder Divergent → Rejoins at GB1 (face)
• Stomach Divergent → Rejoins at UB1 or ST1 (face/eye)
• Small Intestine Divergent → Rejoins at UB1 (face/eye)
• San Jiao Divergent → Rejoins at SJ16 or GB12 (neck/base of skull)
• Large Intestine Divergent → Rejoins at LI18 (neck/throat region)

The San Jiao Divergent is unique in that it follows a descending trajectory rather than ascending, aligning with its role in regulating the Three Burners.  

 

 Divergent Meridian Pathways

Divergent Meridian Pair	Passes Through the Heart?	Notes
Bladder/Kidney	✅ Yes	Bladder Divergent disperses in the cardiac region. Kidney Divergent connects at the root of the tongue, where it meets the Heart Luo-Connecting Vessel.
Gallbladder/Liver	Maybe	Gallbladder Divergent crosses the Heart and esophagus. Liver Divergent does not, but joins the Gallbladder Divergent.
Stomach/Spleen	✅ Yes	Stomach Divergent enters the Heart. Spleen Divergent follows the Stomach Divergent.
Small Intestine/Heart	✅ Yes	Small Intestine Divergent directly enters the Heart.
San Jiao/Pericardium	✅ Yes	San Jiao Divergent is distributed to the Pericardium, linking it to the Heart. Pericardium Divergent converges with the San Jiao Divergent.
Lung/Large Intestine	❌ No	Lung Divergent passes through the chest but does not enter the Heart.

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Reevaluating the Classical Understanding of Divergent Meridians

Given the historical ambiguity surrounding their function, a modern reassessment is helpful. When we reconsider their application through the lens of neurophysiology and autonomic regulation, we begin to uncover a reproducible framework for their clinical use.  The Divergent Meridians were never assigned their own acupuncture points in classical texts. Instead, they diverge from primary channels at major articulations, directing Wei Qi inward to the Zang organs—a function that mirrors the autonomic balance between sympathetic defense (Yang) and parasympathetic restoration (Yin).

A key anatomical feature of the Divergent Meridians is that their reconvergence points are all located above the neck, in regions that exert significant influence over autonomic regulation. The cervical and brainstem regions are predominantly parasympathetic-driven, and the Divergent Meridians’ reconvergence points intersect directly with plexuses that influence respiration, vagal tone, and cardiovascular control systemically, including the middle and inferior cervical ganglia. Because they sit above the emergence of the sympathetic chain (T1), their anatomical positioning reinforces a role in maintaining parasympathetic patency.    

 From a modern clinical perspective, the Divergent Meridians seem to function as autonomic hinges—locations that can restore vagal tone through retained primitive reflexes and neuromuscular bracing patterns in the sinews. Their deep trajectory not only carries defensive energy (wei /sympathetic) to the viscera but also passes through the heart, mirroring the efferent motor pathways from the vagus nerve to the yin viscera.   Given that the vagus provides the dominant parasympathetic innervation to the thoracic and upper abdominal organs, this suggests a fundamental relationship between the two. 

The Autonomic Role of the Divergent Meridians

Because many Divergent Meridians are said to pass through the heart, their activity intersects with autonomic processes regulated by the HPA axis, as any physiological system involving the heart will have some degree of interaction with stress response, hormonal regulation, and homeostatic balance. Their ability to store and release unresolved physiological states reflects the intermittent way that the autonomic nervous system is mediated by primitive reflexes, cranial nerves and limbic-driven emotional responses. These pathways dictate the body's capacity to shift between defensive activation and parasympathetic rest and repair, making them central to both acute survival responses and long-term autonomic regulation.),

Clinically, I have observed that when successful in restoring vagal tone through these reflex pathways often makes the Divergent Meridians visible directly in the tissue. These changes are immediately palpable to both the patient and provider and these have been documented extensively in clinical photographs.

Reflex Integration, Sinew Channels, and Divergent Meridians

Once an injury or complaint is tied to a retained reflex—particularly when spasticity has set in through the sinew channels—it will not resolve through acupuncture or massage alone. Spasticity in the fascia is a clear indicator of conflicting signals that originate in more primitive regions of the brain. Cranial nerves play a key role in this process, as they are resource-intensive and, when reactivated due to trauma or injury, indicate a system in a state of high dysregulation.  This typically manifests as sympathetic dominance (Yang), dorsal vagal freeze (Yin) or a combination of both.

Without resolution, the brain begins to diminish both afferent and efferent signaling because these pathways are not being properly utilized. Cranial nerve involvement and PR demonstration further impairs the brain’s neuroplastic function. Neuroplastic improvements from physical therapy (PT) cannot be realized unless the nervous system remains in a balanced homeostatic state that supports tissue repair and regeneration.

This is precisely where this style of acupuncture is most beneficial. Spasticity patterns cannot be "massaged out" because they are not simple muscular contractions—they are neurologically driven conflicts between flexion and extension synergies that are governed by more primitive regions of the nervous system. However, by manually restoring vagal patency through the local tissues, we provide the nervous system with the opportunity to reestablish proper autonomic signaling. Once this state is restored, normal tissue repair and neuroplastic functioning resume, and it becomes the patient’s responsibility to reinforce and integrate these changes through intentional movement, PT, or other rehabilitative exercises.

Divergent Meridians in Reflexive Orthopedic Injury Recovery

While the Divergent Meridians can be helpful when addressing chronic neurogenic dysregulation, they are equally powerful in the treatment of reflexive orthopedic injuries—particularly those with a strong emotional or autonomic imprint. When an injury is tied to a recent event, catharsis can be a key mechanism for resolution. If the patient connects emotionally with an event near the onset, the autonomic holding patterns often release in real time, with dramatic shifts on the table. 

The Divergent Meridians can help facilitate the transition from structural restriction to emotional processing, making it a valuable tool for addressing both physical and autonomic components, particularly in recent injuries.

 

Case Study: Sciatic Pain and Unresolved Early Trauma

Patient Profile

• Age/Sex: 74-year-old female

Chief Complaint: Recent onset of sciatica affecting the right hip joint, with radiating pain through the lateral and medial groin (6 weeks) despite an active lifestyle. Pain rated 6/10, significantly impacting mobility and preventing participation in yoga and pilates.  She mentioned an upcoming MRI, expressing unease and hesitancy about the procedure. She described mild claustrophobia and discomfort with hospitals but did not initially report any emotional trauma or recent life stressors.

• Diagnosis: Sciatica due to Qi and Blood Stagnation in the Leg Shao Yang and Yang Ming Sinew Channels.  Retained Core Tendon Guard with spasticity though the anterior ASIS, pelvis, quads and IT band.  (Liver, GB and ST Meridians)
• Relevant History: Occasional chronic sciatica, but otherwise active with Pilates, yoga and walking. No recent injuries.
• Objective Findings: Patrick’s (FABER):  +; (-) SLR, Kemps.  No pelvic obliquity or SI joint dysfunction.

·         Treatment included reflex-based acupuncture and manual tissue work targeting the ST and GB Divergent meridians, with a focus on the hip joint, iliopsoas, and sacral fascia.

During the second session, the patient recalled a childhood tonsillectomy at age three, resulting in severe hemorrhaging and a near-death experience. She had never consciously processed this event, otr even thought about it. As she spoke about it and connected with the associations between the experience and her pending MRI, her hip joint released spontaneously, and she experienced complete resolution of pain by the end of the session.

The following week, she completed the MRI without distress and has remained pain-free.

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I've encountered similar injuries in individuals undergoing significant life transitions, like a move or job change. Essentially, the injury and subsequent myofascial issues reflect a deep internal 'no,' resistance, or other unrecognized fear-based fascia patterns.

This case study illustrates the deep connection between sinew channels, autonomic reflex patterns, and the limbic system (emotional processing).  In a healthy nervous system, primitive reflex responses in the sinews were meant to evolve into emotional rather than structural responses, forming the foundation of personality structure. When this process is disrupted from trauma or injury, however, the ANS or the limbic system can remain stuck in more primitive autonomic loops that contribute to heightened emotional reactivity, impaired stress responses, and recurring / intermittent myofascial holding patterns.

Autonomic Dysregulation in Chronic Neurogenic Conditions

While acute orthopedic injuries with a strong emotional trigger can resolve quickly, chronic systemic dysregulation patterns in conditions like MS, Parkinson's, and Long COVID require a long-term process of consistent autonomic harmonization. Autonomic dysregulation is not merely about muscular strength—it reflects an entire system struggling to regulate afferent and efferent signaling. In these cases, autonomic restoration is not just supportive; it is foundational for any meaningful neuroplastic progress.

In my clinical experience, the most profound effects on autonomic balancing occur when using two or more Divergent Meridians in combination, alongside a parasympathetically supported, painless needle style. This dual-meridian approach facilitates a more complete restoration of vagal tone through the sinews, reinforcing long-term neuroplasticity. While this method shows promise, further research and exploration are necessary to fully validate its effectiveness. When combined with reflex integration and fascial release techniques, these approaches form a potential treatment pathway for sustainable neurophysiological change.

 

References

• Al-Khafaji, M. (2007). A Manual of Acupuncture (2nd ed.). Journal of Chinese Medicine Publications.
• Deadman, P. (2007). A Manual of Acupuncture (2nd ed.). Journal of Chinese Medicine Publications.
• Fratkin, J. (n.d.). More Divergent Channel Treatment (Part 4). Dr. Jake Fratkin. Retrieved March 13, 2025, from https://drjakefratkin.com/3-level-najom/part-4-more-divergent-channel-treatment/
• Levine, P. (1997). Waking the Tiger: Healing Trauma. North Atlantic Books.
• Levine, P. A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books.
• Low, R. H. (1984). The Secondary Vessels of Acupuncture: A Detailed Account of Their Energies, Meridians, and Control Points. HarperCollins.
• Lowen, A. (1975). Bioenergetics: The Revolutionary Therapy That Uses the Language of the Body to Heal the Problems of the Mind. Penguin Books.
• Maciocia, G. (2005). The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists (2nd ed.). Churchill Livingstone.
• Mastagova, I. (2005). Integrating Primitive Reflexes for Neurodevelopment. Neurotherapeutics Press.
• Moffitt, J. (2025). Neuro-Somatic Mapping of Emotional States: The Interplay of Bioenergetic Character Structures, Fascia, and Autonomic Regulation. LinkedIn. January 2025.
• Moffitt, J. (2025). The Role of TCM Sinew Channels in Emotional Integration and Vagal Tone Restoration. LinkedIn. January 2025.
• Myers, T. W. (2020). Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Churchill Livingstone.
• Porges, S. W. (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. Norton & Company.
• Pryor, K. (2020). Ten Fingers, Ten Toes, Twenty Things Everyone Needs to Know: Neuroplasticity for Children. Karen Pryor Publications.
• Rosen, J. (2020). Unshakable: Healing the Roots of Trauma. Mindful Living Press.
• Soulié de Morant, G. (1939). L’Acupuncture Chinoise. Éditions Payot.
• Stecco, C. (2015). Functional Atlas of the Human Fascial System. Elsevier Health Sciences.

 

 

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Join me this May for Intro to Polyvagal Acupuncture through eLotus—a deep dive into nervous system regulation through the lens of classical acupuncture. This course will explore how autonomic function, primitive reflex integration, and sinew channels intersect to restore physiological balance.