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Tags: chinese, debunked, energy, mai, medicine, meridian, model, qi
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such great, informative articles! im learning so much =) cant wait for the next one!
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thanks so much for sharing your wisdom! fascinatinggggggg!
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Thanks Laura and Keren. Glad you’re enjoying the articles.
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This is a good series of posts. Can’t wait to hear what you have to say about GERD.
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Some comments on what I agree and disagree with: I’ll start with where I disagree.
The Mawangdui medical texts unearthed in the 70s from Mawangdui show that there is a possibility that the channels actually predate the points. I refer you to the chapter on the subject on Giovanni Maciocia’s work “The Channels in Chinese Medicine” where he traces the history of channel theory. Correct me if I am wrong (I am reading your blog at 1 Am my time… not very healthy!) but it would seem to me that the modern concept of meridians is being presented as being a consequence of de Morant’s work.
Also I would like to point out that the definition of Qi is definitely not that simple. Qi is more than just air or oxygen, and while I am sure you know this I want to reiterate it to other readers. I personally translate Qi as “function” or “dynamism” or quite simply “what makes something tick”. I refer you to a book (I forgot the author) “A Brief History of Qi” where it analyzes the concept of Qi from a historical, cultural and linguistic perspective. My point is while I agree that it is possible to translate Qi as oxygen, it is not the only applicable translation. Chinese words are notorious for multiple meanings depending on context and what these words are combined with. Chinese Medicine also has different kinds of Qi with different names – I believe that oxygen is just one of them. Pectoral (zong) Qi can refer to our sinoatrial node, Nutritive (Ying) Qi could refer to glucose, while Defensive (Wei) Qi can refer to our immune system in general… In this sense I believe my translation of “function” or “dynamism” is applicable. By the way, according to both HDNJ and Nan Jing (classic of difficulties) the Qi that flows through the channels is defined as nutritive Qi.
Where I DO agree is that Chinese medicine is definitely not an energy medicine in the modern sense of the word. I was recently asked this question when I guested on a radio show and my answer was thus: it depends on how one defines energy. If by energy we mean some quasi-mystical “force” then no. If by energy we mean the ability of the body to function and do it’s job then yes.
You are definitely on target with regards to the nodes and organ referred pain.
Also, the meridians are hardly invisible. I have had several experiences of meridians (most often the yangming meridians of hand or foot) actually becoming visible (most often reflective of stomach heat) and colored red. If I may ask for you email address I can certainly send you some photographs.
One more thing: I heartily agree that the term “meridian” is inaccurate and misleading. A meridian, in the most common use of the word in the english language, implies a static line. I prefer the word “channel” in the British sense since it implies a flowing, dynamic body of water, through which goods are transported (i.e. English Channel). Before I forget, many people assume that it is only Qi that flows through the channels. Actually it is both Qi and Blood, according to Chinese theory. Note that the Chinese concept of Blood is different from the western. In addition to the “red stuff” it also indicates the functions of Blood. So in a way, following your theory, Qi can be oxygen and Blood (chinese sense) can be glucose (since Blood deficiency can cause light headedness – hypoglycemia?)
I do appreciate your efforts in demystifying Chinese medicine. This is essential in our attempts to provide people with the best possible health care they can get. -
My understanding is that the meridians are spaces over the muscle bellies and between organs where extracellular liquid can flow. And my understanding of the movement of qi is the passage of hydronium ions through the fluid. When the Koreans injected radioactive isotopes into points they followed meridians instead of known structures. And when I was in Bejing, research was being done with soundwaves confirming the meridian locations.
Now in dissection I cannot say that I ever saw blood vessels following the jing luo, except perhaps the chong meridian. So what structures do you posit follow the meridians? -
Just turned on to your column and must say highly illuminating. You showed me a side of TCM that I did not know about and I thought I understood this stuff. Thanks for that. I just put up a blog piece last week called “Chiropractic, Acupunture, and Integrative Medicine: The Power and Politics of Healing” on my website http://www.rickyfishman.com (Check it out if you like) Now I have to re-think some of my perspectives.
Thanks a lot!!
Ricky Fishman -
I’m arguing that the meridians that we were taught in school were an invention of Soulie de Morant, and that what the classical Chinese were referring to are longitudinal distributions of blood vessels, muscle spindles and nerves. This is what I believe the historical evidence and modern scientific understanding of the body supports, and what makes the most sense to me. Thanks for your comments!
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Thanks for your comment, Ricky. I’ll check out your blog.
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I respectfully disagree about meridians being an invention of Soulie de Morant, at least in terms of the pathway direction. The Huangdi Neijing was very clear on this, as were later texts which westerners never even touched until recently. I refer you to the Zhenjiu Jiayijing as a way to see the HDNJ as edited by Huangfu Mi, who lived in the 3rd century AD. The classical pathways were clearly defined then, and they do not necessarily correspond to blood vessels, spindles and nerves. However, I would like to propose an alternative: have you thought about their referring to dermatomal lines? I read somewhere (forgive me, I cannot recall where) that acupuncture meridians may represent functional dermatomes and are classifiable by embryonic layers (ectoderm, endoderm, mesoderm…)
However, the important thing for me is not what they are – I’ve long given up on trying to understand it perfectly. What’s important to me (and I’m sure to everyone) is that they form a theoretical basis for a medicine that works. Just today, in my clinic, I once again demonstrated channel theory. In a patient with acute shoulder pain, I first isolated through physical examination which channel was affected. In this case two were affected – triple warmer and small intestine meridians. I used four distal points all located nowhere near the shoulder, then needled strongly and withdrew almost immediately. Instantaneous restoration of active range of motion and dramatic reduction of pain.
My point selection was based on theories put out not in HDNJ but in Nan Jing (Classic of Difficulties), which clearly shows channel theory as pathways of Qi and Blood (jingluo) as distinct from muscles and blood vessels (mai).
I guess my point is that while I agree that to label acupuncture as an “energy medicine” is an affront to the practice, I have to disagree with the notion that the pathway of the channels is just a “connect the dots” thingee by de Morant.
@Karen Yes that is one possible explanation for the meridians. Chris’ is another. Mine is another. There doesn’t have to be one single explanation but I think what is definitely undeniable is a) the channels represent something dynamic and flowing – not static, b) that this something is hardly immaterial but is part of normal hemostasis and that c) the needling sensation propagated by acupuncture seems to be the basis for mapping these channels. The fact that this needling sensation and later analgesic effect is blockable by naloxone definitely suggests a physical, physiological mechanism as opposed to some “new age” energy concept. -
@ Chris just wanted you to know that I know that you already understand the basis of my treatment (using shu stream points) but I was just elaborating it for the benefit of your lay readers.
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Phillip,
I’m enjoying your comments and I appreciate your contribution. I agree that there is more than one way to understand the medicine. I’m presenting a view that I believe is supported by historical evidence, and that makes the most sense to me.
I’d like to address a few of your points. According to Harper in his paper on the Mawangdui manuscripts, the word “mai” refers to blood vessels with some running vertically from foot to head. Both the Neijing and the Mawangdui used an anatomical notation approach in terms of yin and yang regions that divided the body into 12 longitudinal areas on each side. The Neijing (LS 10, LS11) provides a full description of longitudinal blood vessels (jingmai) either supplying (arterial) or draining (venous) each side of the body. Their pathway descriptions are in sufficient detail to identify the actual vessels as they are presently understood (See Kendall’s Dao of Chinese Medicine, Ch. 8 & 9 for more on this).
Paul Unschuld’s survey of the Neijing also indicates that the mai and conduit vessels are described as definite anatomical, tubular structures that carry blood. And as I’ve pointed out, the blood of the ancient Chinese is exactly the same as our blood today! They knew very well from dissections that it is a material substance that flows through the blood vessels.
Another historical fact supporting the blood vessel theory is that sharpened stones and bones discovered in China that have been dated to 6000 BC are now thought to have been used for bloodletting. There is considerable evidence that bloodletting preceded acupuncture. If the Chinese were bloodletting, they certainly understood that what they were bleeding were anatomical blood vessels – not energetic meridians.
My understanding is that the notion of a non-material form of blood came much later in Chinese medicine, and was a post-hot attempt to fit Chinese medical theory into contemporary understanding of physiology. Prominent scholars of Chinese medicine have pointed this out:
“Over several centuries, clinical realities that did not fit into an existing theory of Chinese medicine were often suppressed to ensure continuity of the theories, in a style that the Chinese call ‘cutting the foot to fit the shoe’.”
- Professor Huang Long-xiang, VP of Acupuncture Institute of China Academy of Chinese Medical Sciences in Beijing and Editor-in-Chief of Acupuncture Research and World Journal of Acupuncture
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I think part of where we are finding difficulty to reconcile our conceptions is the the placement of a seeming dichotomy between the “material” and “non-material”. We both agree that “Qi” and “Blood”, “Channels and Collaterals” definitely refer to something physiologic (I say physiologic and not anatomic because I want the laymen readers to imagine dynamic processes and not static structures) as opposed to “energy” medicine.
Comment/Question: we both know that moxibustion and bloodletting both preceded acupuncture (as we know it – inserting fine needle and getting “deqi” sensation) my question is – which do you think came first?
Another comment: while I do agree that a cursory reading of the classics does seem to indicate the recognition of jingluo (channels and collaterals) as literal blood vessels, does that mean that they are recognized ONLY as such? My belief, supported by clinical practice, seems to hint to me that at the very least, the “lines” as mapped out in Chinese charts even before De Morant drew his connect-the-dots can also be interpreted to mean the direction of flow of needling sensation. Just because one interpretation is true doesn’t mean the other is automatically false. (remember how Qi flow in the meridians seems to go in different directions as specified either by horary flow of Qi as opposed to five transporting points flow?) Note that I am not disagreeing with you per se, but pointing out that our viewpoints are not necessarily mutually exclusive. That sort of decartesian “true” and “false” absolutism is precisely the kind of thinking that oriental philosophy does so well without.
Which brings us to Blood – I am not sure I am comfortable with the notion that material and non-material “forms” of Blood again need have to be mutually exclusive. Can we agree in saying that the Chinese concept of Blood at the root level is at par with the western concept, but with a broader application? That’s how I explain it: just like the zangfu, the Chinese word “blood” refers to both the substance and the function. I say this because I am reminded that Blood, being yin, doesn’t necessarily have a non-material sense. The non material sense of blood is Qi, isn’t it? (Qi here taken to mean the dynamism of blood, the flow…)
God I love intelligent discussion about chinese medicine! It is a refreshing departure from the usual claptrap. -
Phillip,
I’d say we’re not far off, but that we may disagree on some issues. Which is fine, of course. There’s plenty of room for different opinions!
Propagated (needle) sensation is transmitted along known nerve pathways, so it seems impossible to me that “meridians” exist outside of these pathways.
I do agree that the Chinese concept of blood is broader than the western concept. And I have found the Chinese concept to be useful in making a diagnosis for herbal prescription. But I understand the Chinese concepts of blood, yin, yang etc. primarily as metaphors for mapping various pathologies that were not understood scientifically 2,000 years ago. They’re still useful today, because the ancient Chinese discovered through experimentation which botanicals were useful for which “pathology map” (i.e. “yin deficiency”). That they figured this out without the benefit of modern science is astounding.
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Chris
The one reason I’m so convinced that the classical channels are indeed true is that I’ve had at least three patients tell me that the needling sensation along the foot yangming channel does follow the slight zigzag between st 38, 39, 40 then 41 for them, especially when I needle both st 36 and st 42.
But yes, we are in total agreement about the metaphors. My world is one where I have to teach western medical students basic TCM concepts. Some of them have had previous encounters with TCM practitioners (many who are MDs/Acupuncturists) and they’re told that they have to “forget” western medicine to understand Chinese medicine.
Hogwash.
I tell them that the secret to understanding Chinese medicine is to do precisely what you’re saying – understand the terms and ideas as metaphors for phenomena that we may give different names to today. Back then they used natural phenomena analogous to environmental conditions. One seething critique of TCM in a medscape.com column a few years ago even used that as “evidence” that TCM is baloney. I countered by saying “so where does that leave ‘modern’ medicine when we use the term inflammation”? No answer from him heh heh.
I am not surprised that ancients could figure out a lot of things just by taking a lot of time to observe phenomena and then try to analyze them. I assume that in a world without television, newspapers or the internet, people had a lot more time to just walk around a park and THINK. Kinda like Newton seeing an apple fall and getting his brain gears turning. -
I expended some effort, in 2006 and 2007, in contacting some relatives of DeMorant, regarding his library of classical Chinese medicine books. I was able to mail a query to his daughter, now in her 90′s who said that the library had unfortunately become dispersed after De Morant died. And I was able to email a newphew of DeMorant who was able to give me the names of a couple of books that DeMorant had used to learn Anatomy and Physiology.
There was said to be a bunch of index cards with various Chinese words and their translations, that De Morant had. Zmiewski, who did the brilliant translation of L’ Acupuncture Chinoise by De Morant, into English, I think mentioned something of them but they remain unavailable.
While I continue to use DeMorant’s book, I eventually discovered van Nghi, Dzung and other more classical books as better sources of “real” Chinese medicine.
If you could mention online sources of classical Chinese medicine books, that would be interesting. On my own, I’ve discovered that the entire “Si Ku Quan Shu”, which includes the “Golden Mirror of Medicine” and the “Ben Cao Gang Mu”, all in Chinese, of course, is available for download from http://www.archive.org However, there is a trick – if you type in “Golden Mirror of Medicine” in English into the http://www.archive.org search engine, it will not find it – you have to use the Chinese characters. For this, I just go to Wikipedia, type in “Golden Mirror of Medicine” in English and then find the Chinese characters in the article and copy and paste those into http://www.archive.org -
Hey Chris,
Just read this article. Where are you getting your information from? I would love to read the articles/books on the subject.
I recently got into a hot debate with a fellow L.Ac. who insists on telling her patients that Chinese medicine is part magic. I think this is a huge discredit to the patient, to Chinese Medicine, and to our profession as a whole. To me the word “magic” implies that the patient is being “tricked” or “fooled” into believing that what we do is helping them. I also think the word magic takes the true healing power away from the patient (because lets face it, we are not healing them, we are guiding their own body’s healing potential). To me there is no magic involved in Chinese Medicine, in fact it is all pretty straightforward and basic, it all can be explained. Although we may not understand it all in terms of western medicine now, we will one day be able to. It is up to our generation of acupuncturist to fuse the two medical models.
When patients ask me how it works I often give reference to the nervous system to explain it. I usually try to simplify it and say that Chinese medicine is a balancing system.
Thanks!
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Hi Dawna,
The references are listed at the end of the text. The Dao of Chinese Medicine by Kendall is the best place to start.
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” Any sufficiently advance technology is indistinguishable from magic.” Arthur C. Clarke
The Chinese description of chi is very analagous to electromagnetism.
The importance of electromagnetic energy and the human body was brilliantly shown by Dr. Robert Becker who using energy (electricity) was among other things able to regrow animal limbs. Documented in his book- The Body Electric: Electromagnetism and the Foundation of Life
His research in the electro-conductivity of collagen in bone give evidence of how advanced chi-kungs such as bone marrow washing work as well as I-Chuan, Yogic stretching, and importance of correct posture to keep bones and tendon in both electrical and structural connection.
Dr. Mae Won Ho further connects the electromagnetic nature of the human body to acupuncture in her paper, “Coherent Energy, Liquid Crystallinity and Acupuncture”, in which she states, “Aligned collagen fibres in connective tissues provide oriented channels for electrical intercommunication, and are strongly reminiscent of acupuncture meridians in traditional Chinese medicine.”
Collagen, Collagen, Collagen, a triple helix, a beautiful spiral, a liquid crystal, sensitive to light, pressure, vibration, and electromagnetism. Is it a coincidence that its spiraling extension is like the movement of chinese internal martial arts.
Lastly I am electrical engineer and have also practiced internal martial arts / qi-gong for many years. With the research of the above and others, good teachers, and discipline (almost daily practice) have all helped me to actually experience chi. Among other experiences, it feels as though the electromagnetic field of my body has increased and unified my body.
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Hi Chris,
If indeed the meridian concept is merely representing the vascular system then how would one rectify the topics of the extradordinary vessels? Specifically the ren du yin qiao yang qiao dai yin wei and yang wei. To my knowledge the concept of these vessels has been around for a very large portion of the history of acupuncture and they do not correlate closely with any vasculature.
It is obvious that you have a deep understanding of the history of chinese medicine and a sharp grasp on the theory of the practice. I would welcome your visit and commentary on my recently launched blog at http://www.acupunctureology.com
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