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Chinese Medicine Demystified (Part III): The “Energy Meridian” Model Debunked

March 8, 2010 in Myths & Truths | 19 comments

ship sailing off edge of world
Note: This is the third article in an ongoing series. Make sure to read the previous articles before reading this one, and check out the next articles in the series afterwards.

“Why does anyone care whether Chinese anatomy and physiology are explained as energy flowing through meridians, or by the circulation of blood, nutrients, other vital substances, and vital air (qi) through the vascular system? The answer to that lies in the moral obligation of every practitioner to provide each patient with the latest medical understanding available.

The need to continually search for the truth is the most fundamental principle of science and medicine… Research so far shows that the true concepts of Chinese Medicine operate under known physiological principles, involving the complex organization of the neural, vascular, endocrine, and somatic systems, sustained by the circulation of nutrients, vital substances, and oxygen from vital air.”

- Donald E, Kendall, “Dao of Chinese Medicine” (2002)

“It is a fact that more than 95 percent of all literature published in western languages on Chinese medicine reflect western expectations rather than Chinese historical reality.”

- Paul Unschuld, historian of Chinese medicine

Continuing from Part II…

De Morant returned to France after his time in China with the intention of teaching Chinese medicine to French physicians. Conveniently, he promoted the idea that Chinese medicine didn’t require an understanding of anatomy and physiology. After all, de Morant was a bank clerk – not a physician – and had no medical training or qualifications to teach medicine at all.

But de Morant did know something about Ayurveda, the traditional Indian medicine based on the idea of energy called “prana” flowing through invisible lines called “nadis”. De Morant applied these concepts to Chinese medicine, even though they are not found in the Huangdi Neijing (HDNJ) or any other classical Chinese medical text.

The main problem with de Morant’s version of Chinese medicine was his representation of qi as “energy”. Almost all of the misunderstanding about Chinese medicine revolves around this mistranslation – which continues to be used despite historical facts that clearly contradict it.

Paul Unschuld, a respected Chinese studies scholar, notes that “the core Chinese concept of qi bears no resemblance to the Western concept of ‘energy’.” 1 Schnorrenberger, another prominent scholar of Chinese medicine, also notes that qi is “certainly not equivalent to the Western term ‘energy’.” 2

De Morant himself admitted that he translated qi as energy, “for lack of a better word.” 3

Therfore, the commonly accepted idea in the west that Chinese medicine is an energetic, metaphysical medicine was singlehandedly created by a French bank clerk with no training in medicine or ancient Chinese language. It is neither historically accurate nor consistent with modern scientific understanding of the body.

Since the energy meridian model is clearly incorrect, we must look to the classic Chinese medical texts to discover the authentic fundamental concepts of Chinese medicine. In the Huangdi Neijing, the Chinese describe the lungs breathing in what they call “da qi”. If you look up da qi in a Chinese dictionary, you’ll see it defined as “great air”. The Chinese explained that the lungs breathed in air, and the lungs extracted the qi from the da qi.

What do our lungs get from the air that sustains life? Oxygen. If you look up qi in a Chinese dictionary, there are ten definitions but not a single one of them is energy. Qi is defined as vital vapor, air, or the essence of air. It can also refer to the function of something (i.e. the qi of an organ would refer to the function of that organ) and the weather. Qi does not mean energy.

Of course the Chinese hadn’t identified the molecule we know as oxygen 2,000 years ago. They didn’t have the technology for that. But they did understand that we extracted something essential to life from the air we breathed, and they knew that this vital air (qi) was circulated around the body to support physiological processes. Therefore the closest translation of qi in a modern medical context is not energy, but oxygen.

The Chinese also described how this oxygen (qi) gets around the body: through the blood. They knew this from the dissections they had performed. The blood of the ancient Chinese is exactly the same as the blood of the 21st century! They knew blood circulated through blood vessels and the vascular system, which they had painstakingly identified and measured.

The word the Chinese used for vessel in the HDNJ is “mai”. Mai is correctly translated as vessel. “Xue Mai” is correctly translated as blood vessel (xue = blood). Morant took the word mai and incorrectly translated it as the French word “meridian”. He did this in spite of the fact that there was no word for meridian in the ancient Chinese language.

Unschuld points out:

“The term ‘meridian’, introduced by Soulie de Morant in his rendering of the concept of jing, is one example among others of what might be called a creative reception of Chinese medicine in Europe and North America in recent years that disassociates itself from historical facts.” 4

The idea that blood, along with mysterious and undefined energy, circulate through invisible “meridians” in the body was yet another creation of Soulie de Morant with absolutely no relationship to what is written about Chinese medicine in the classic texts.

De Morant also photographed ancient diagrams of acupuncture points depicted on the body. He then drew a line between all of the points, creating the concept of a meridian system for the first time. Meridian systems aren’t in the original texts. The original texts have drawings of major arteries going from the trunk into the legs. The points are arranged along these arterial routes.

The word De Morant translated as point is “jie”. Jie is more correctly translated as node, neurovascular node, or critical juncture. The Chinese knew that these nodes represent areas of fine vascular structures (arterioles, capillaries and venules – although they didn’t call them this at the time) and related nerves. Even 2,500 years ago, the superficial nodes were recognized to have afferent and efferent neural properties.

Modern research has demonstrated that neurovascular nodes (acupuncture points) contain a high concentration of sensory fibers, fine blood vessels, fine lymphatic vessels, and mast cells. These nodes are distributed along longitudinal pathways of the body where the collateral blood vessels supply the capillaries and fine vessels. The corneum stratum of the skin in these areas is slightly thinner with a lower electrical resistance. They also contain more sensory nerves, and have more fine vessels with sequestered mast cells than non nodes. 5

Ancient Chinese physicians recognized that neurovascular nodes (acupuncture points) on the surface of the body could reflect disease conditions in the internal organs, and that these same nodes could be stimulated to relieve pain and treat internal organ problems. This was a revolutionary discovery that formed the theoretical basis for acupuncture treatment. It was not until the early 1890s that this phenomenon of organ-referred pain was discovered in the West, by British physician William Head.

When the terms qi (oxygen), mai (vessel) and jie (neurovascular node) are properly translated, it becomes clear that there is no disagreement between ancient Chinese medical theory and contemporary principles of anatomy and physiology. Chinese medicine is not a metaphysical, energy medicine but instead a “flesh and bones” medicine concerned with the proper flow of oxygen and blood through the vascular system.

On his deathbed in 1955, de Morant admitted that what he referred to as meridians were in fact blood vessels. However, he still thought that energy (qi) flowed through the blood vessels.

As it turns out, de Morant wasn’t too far off. Energy is an abstract concept that means “in work”. It can’t be circulated in the blood. However, the potential for energy, in the form of oxygen and glucose, is transported through the cardiovascular system.

Energy production within each cell is initiated by breaking down each molecule of glucose (from absorbed nutrients) to form two molecules of pyruvate. Pyruvate produced in the cell cytoplasm is taken up by the mitochondria and enters the Krebs cycle.

The Krebs cycle involves a cyclic seris of reactions that convert ADP to ATP, the fundamental unit of energy in the body. This requires inhaled oxygen supplied by the red blood cells via capillaries.

This energy production cycle was discovered by Albert Szent-Györgyi and Hans Adolph Krebs well before de Morant died, in 1937. Had de Morant been aware of their work, he would have recognized that energy does not flow through the blood vessels. It is transmitted in its potential form, oxygen and glucose.

In the next post we will discuss a more authentic understanding of how Chinese medicine works, supported both by classical Chinese writings and modern scientific inquiry.

Continue to the next article.

  1. Unschuld, PU. Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in Ancient Chinese Medical Text. Berkeley. University of California Press. 2003 ↩
  2. Schnorrenberger, CC. Morphological foundations of acupuncture: an anatomical nomenclature of acupuncture structures. BMAS Acupuncture in Medicine, 1996. Nov;14(3):89-103 ↩
  3. Soulie De Morant, Georges. L’Acuponcture chinoise. Tome I L’ energie(Points, Meridians, Circulation). Mercur de France, 1939 (French) ↩
  4. Unschuld, PU. Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in Ancient Chinese Medical Text. Berkeley. University of California Press. 2003 ↩
  5. Kendall, Donald. The Dao of Chinese Medicine. Oxford University Press, 2002. ↩

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Chinese Medicine Demystified (Part II): Origins of the “Energy Meridian” Myth

March 5, 2010 in Myths & Truths | 13 comments

energy meridiansNote: This is the second article in an ongoing series. Make sure to read the first article before reading this one, and check out the next articles in the series afterwards.

As an acupuncture student, I often like to ask people if they know what the word qi (sometimes spelled “chi”) means.

I get all kinds of answers. Some people don’t have any idea. Some guess it’s a kind of tea, like chai tea. Some say it has something to do with martial arts. Others say it means balance or flow. But those who’ve been to an acupuncturist, or at least know someone who has, say that qi means energy.

They say that because that’s what their acupuncturist told them. And their acupuncturist told them that because that’s what the acupuncturist was taught in school. That’s the definition of qi in the textbooks about Chinese medicine that we study in the west.

These textbooks teach that qi is an energy that moves through your body in meridians. A meridian is a metaphysical line “juxtaposed” on the body. It has no actual location inside of the body. In other words, it’s not really there. According to these textbooks this mysterious energy called qi flowing through these nonexistent lines called meridians forms the conceptual basis of Chinese medicine.

This is the definition of Chinese medicine that causes snickers, smirks and shaking heads amongst the scientific crowd – which is to say almost every doctor or medical professional trained in the west. But is this definition even accurate?

Much of what we know about Chinese medicine comes from a book called the Huangdi Neijing (HDNJ), or Yellow Emperor’s Internal Classic. There’s some controversy about when it was written, but most scholars agree that it was about 2,000 years ago, sometime between the second and first century BCE. The HDNJ is a massive encyclopedic text of Chinese medicine. You can think of it as their version of the Merck Manual.

The HDNJ had several sections. One was on anatomy. If you recall from the previous post in this series, the Chinese were performing detailed dissections 500 years before the birth of Christ. They listed the average weight, volume and measurements for all of the internal organs. They named the organs and described their functions. (In fact, they knew that the heart is the organ that pumps blood through the body more than 2,000 years ago. This wasn’t discovered in western medicine until the early 16th century.) They knew which vessels flowed away from the heart, which vessels flowed toward the heart, and which vessels supplied which organs.

The HDNJ also had detailed sections on pathology. They described how diseases develop and how to treat those diseases with acupuncture, herbal medicine, massage and dietary and lifestyle changes. In short, the Chinese were practicing truly preventative medicine 2,500 years before the term was even coined.

The HDNJ is a remarkable book. But early western scholars had a problem. The HDNJ is written in a dialect of Chinese that hasn’t been in common use in China for more than a thousand years. You could show it to a modern Chinese person and they wouldn’t be able to read it.

Several westerners took a crack at translating it. One of the first was a Dutch physician named Willem ten Rhijne. Ten Rhijne worked for the Dutch East India Company in Japan from 1683-1685. He reported clinical success by Chinese and Japanese practitioners in treating a wide range of disorders, including pain, internal organ problems, emotional disorders and infectious diseases prevalent at the time. Interestingly enough, Ten Rhijne accurately translated the Chinese character for qi as “air”, not energy, in his reports to the Dutch government.

But the translation we’re most familiar with, and the one that became the source for all of the textbooks used in western schools of Chinese medicine, was done by a man named Georges Soulie de Morant.

De Morant was a French bank clerk who lived in China from 1901 to 1917. He was enamored with Chinese culture and philosophy, and became interested in Chinese medicine during his stay. He decided to translate the HDNJ, in spite of the fact that he had no medical training nor any training in ancient Chinese language.

It was a huge undertaking for a French bank clerk to translate a 2,000 year old medical text written in an extinct Chinese dialect into a modern romance language (French). Under the circumstances, de Morant did well in many respects. But he made some huge mistakes that had serious consequences for how Chinese medicine has been interpreted in the west.

In the next post, we’ll look at those mistakes in more detail. We’ll also replace de Morant’s fictional “energy meridian” model with a new – or rather old – model of Chinese medicine that is both historically accurate and consistent with modern scientific principles of anatomy and physiology.

Continue to the next article.

References

Kendall, Donald, The Dao of Chinese Medicine, Oxford University Press, 2002

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Chinese Medicine Demystified (Part I): A Case of Mistaken Identity

March 4, 2010 in Myths & Truths | 39 comments

chinese physicianNote: This is the first article in an ongoing series. Make sure to check out the next articles when you’re finished with this one:

I’m sure you’re at least somewhat familiar with Chinese medicine and acupuncture by now.  It’s received a lot of media coverage over the last decade, and insurance companies are now covering it in many states. But even though an increasing number of people are using acupuncture to address their health problems, most still don’t understand how Chinese medicine works.

We’ve been told that Chinese medicine involves mysterious energy called “qi” circulating through invisible “meridians” in the body.  When the flow of qi through our meridians becomes blocked, illness results.  The purpose of acupuncture and other Chinese medical therapies (like herbal medicine and qi gong) is to promote the proper flow of qi through the meridians, thus restoring health.  Sound familiar?

If you’ve ever been to an acupuncturist in the west, I’m sure you’ve received some version of this explanation. After all, this is what they teach in acupuncture school. I know this because I’m in my final semester of studying Chinese medicine, and this is the explanation in our textbooks.

Understandably, these fundamental concepts of Chinese medicine have been difficult for western patients and doctors to accept.  If you sit a doctor down who has had ten years of post-graduate medical training and tell him that an unidentified energy called qi flowing through imaginary meridians is the key to health and disease, he’s going to look at you like you’re crazy.  And I don’t blame him.

What if I told you that nearly everything we’ve been taught in the West about how Chinese medicine works isn’t accurate?  What if I told you that Chinese medicine isn’t a woo-woo, esoteric “energy medicine” at all, but instead a functional, “flesh and bones” medicine based on the same basic physiology as western medicine?  And what if I told you I could explain the mechanisms of Chinese medicine in simple, familiar terms that any eight year-old could understand and even the most skeptical, conservative doctor couldn’t argue with?

Here’s the thing. The “energy meridian” model that has become the default explanation of Chinese medicine US is not only out of sync with our modern, scientific understanding of the body – it’s also completely inconsistent with classical Chinese medical theory.  In other words, we’ve made up our own western version of Chinese medicine that has little to do with how it was understood and practiced since it began more than 3,000 years ago in China.  

This gross mischaracterization has kept Chinese medicine on the fringes of conventional medical care since the 1930s and 1940s.  Most doctors and patients have simply been unable to accept the explanation they’ve been offered for how acupuncture works. The result is that acupuncture has come to be seen as either a mystical, psychic medicine or a foofy, relaxing spa-type treatment.

And that’s a big shame. Because Chinese medicine is in fact a complete system of medicine that has successfully treated many common health conditions for more than 2,500 years. Chinese medicine was passed through the ages in an unbroken lineage of some of the best minds of China. It was used by emperors and the royal courts to help them live into their 90s and stay fertile into their 80s at a time when the average life expectancy in the west was 30 years.

The Chinese were performing detailed human dissections where they carefully measured the blood vessels and weighed the internal organs at a time when western physicians thought the body was made up of “humors”. These dissections helped Chinese physicians to discover the phenomenon of continuous blood circulation 2,000 years before it was discovered in the west. The discovery of blood circulation is still considered the single most important event in the history of medicine.

Chinese medicine has been around for a very, very long time. The first evidence of the type of medicine that led to the Chinese Medicine in use today dates back to about 6,000 BC, which was during the neolithic (new stone age) period. Stone tools from this period have been found that were specially shaped for making small incisions in the skin, which was the early form of acupuncture. That’s 8,000 years of uninterrupted use. To put this in perspective, western medicine as we’ve come to recognize it today wasn’t even invented until the 1350s (the middle ages), which makes it less than 700 years old. Ah hem.

Let me ask you this. Do you think Chinese medicine would have survived for more than 3,000 years and spread to every corner of the globe if it wasn’t a powerful, complete system of medicine?

The reason Chinese medicine isn’t more popular in the west is that it’s completely misunderstood even by the people who practice it. And as long as acupuncturists continue to promote the “energy meridian” model as the explanation for how Chinese works, it’s destined to remain a fringe alternative modality.

In the next article I’m going to give you an explanation for how Chinese medicine works that is not only historically accurate, but also consistent with the principles of anatomy and physiology as we understand them today. I’m also going to tell you how this blatant mischaracterization of Chinese medicine in the west came about.

Read the next post in the series: Chinese Medicine Demystified (Part II): Origins of the “Energy Meridian” Myth

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