Using the Channel Systems of Acupuncture to Unravel the Mysteries of Disease Progression
By Nicholas Sieben, LAc
Wind is a philosophical representation of change in the Chinese classics. It is also acknowledged as the root of all physiological disturbance. It is stated in chapter 3 of the Su Wen that wind is "the cause of hundreds of diseases."
Within classical thinking, cold, damp and heat are factors representing the body's reaction to wind. Cold traps wind in the body, viewed philosophically as hesitation to change. Damp inhibits qi and represents confusion with change. Heat causes increased movement and dispersal, representing urgency within change.
The three manifestations of external wind are defined as Tai Yang, Shao Yang and Yang Ming. These classifications refer to stages of pathological progression, as well as to zonal acupuncture channels.
Tang Dynasty patriarch Sun Si Miao viewed pathology as inseparable from our reaction to the world. Wind is a constant in life. Change is the one sure thing. How we "course the wind," or react to change, determines the weather within our bodies. Chapter 3 of the Ling Shu introduces this theme, saying pathology is always a struggle between the "zhu" host (physiology) and "ke" guest (pathology): a struggle between ourselves and the world as we try to establish homeostasis. The guest is not necessarily negative. Pathology results only if we have resistance to wind.
Sun Si Miao presents a Daoist view that is somewhat in conflict with the Confucian concept of perverse "xie qi" and "zheng" upright qi. One view sees the world in terms of good and bad, the other believes it's our reaction that creates problems: change our mind, and we transcend the difficulty.
The channel systems of acupuncture are tools, illustrating complex pathological and physiological theories presented in the Nei Jing. Jeffrey Yuen often likens acupuncture channels to "roadways" we take in life. The Primary Channels are the main roads, representing our "Ming" or destiny. Each "secondary channel" or "collateral" can be seen as a distraction: side roads we may veer off onto.
Certain philosophical traditions believe the collaterals are a necessary part of life: we learn about our true nature through the deviations. Ideally, wind brings us closer to understanding our true nature. The Secondary Channels help us understand our reaction to change, and where we may be stuck.
The foundation of all Chinese medical theory is contained within the Nei Jing. The Su Wen provides basic pathological and physiological theories, while the Ling Shu illustrates these theories through the application of acupuncture. The Channel Systems of acupuncture detail the many manifestations of wind as we contend with it in life.
Chapter 3 of the Su Wen details the progression of wind as it enters and moves deeper into the body. Wind enters the skin and affects the sensory orifices; it can travel into the channels and collaterals, causing turbidity, affect the blood and create blood heat and damp-heat. When wind enters the channels, it can become asymptomatic as it's trapped by yin factors such as dampness and blood. This is classically known as "Feng Xie": perverse qi. Trapped wind generates heat which burns the body's yin, leading to internal wind, leakage and yin deficiency.
Basic pathogenic progression is discussed in the Su Wen anatomically, traveling from the head to the chest to the abdomen. The skin and head are represented by the Sinew Channels; the chest by the Luo Vessels; the abdomen by the Fu organs. After the Fu have been affected, pathology moves into the lumbar where it has access to the Bladder Shu points and the Zang organs. This is where serious conditions, called "Zang Wind" in the Su Wen, develop. Two major channel systems connect with the Zang Fu: the Primary Channels and Divergent Channels.
The concept of the constitutional yuan level is mentioned briefly throughout the Nei Jing. It became more developed in later classics such as the Nan Jing. The yuan level is considered the basis of life and the root of the body. Pathogens that drain into the yuan level can become lodged in a dormant state. Up until the Ming Dynasty, the yuan level was considered out of reach to medical intervention. Once something was absorbed by this level, it became the seed of one's next incarnation. Within the channel systems, the yuan level is represented by the Extraordinary Vessels and the Curious Organs.
Li Shi Zhen was the major Ming Dynasty contributor to understanding the Extraordinary Vessels and their clinical use. Prior to this time, Gallbladder was the channel and organ used to connect to the constitutional level. The Gallbladder is considered the bridge between the post-natal and pre-natal levels. It is historically used when pathology, usually in the form of hot-phlegm, travels into the source, affecting the level of evolution, defined by the Curious organs and vessels. The Curious Organs include the uterus, bones, brain and marrow, as well as the Extraordinary Vessels themselves. They are the gateway for pathology to pass into the DNA to be passed onto future generations, or carried into subsequent lives, depending on cultural and historical belief systems.
When the body is confronted with wind that it finds unmanageable, a safeguard mechanism is activated. Certain "collaterals" enact a process called "latency," transporting the pathogenic factor into a dormant, hidden state away from primary physiological function. The Luo Vessels and Divergent Channels try to prevent pathological progression into the organs. If pathology reaches the Zang Fu, physiological function becomes disturbed, giving rise to serious organic problems.
External pathogens enter the body through the Sinew Channels, representative of the wei level of energetics. If the wei level fails to contend with a pathogen, the ying level, as represented by the Luo Vessels, inherit the problem. Ying qi, in the form of blood, is used to trap the unresolved pathogenic factor in a latent state through blood stasis.
Luo Vessels hold onto unresolved pathology. They do not treat the pathology they inherit; they are like containers, trapping unresolved pathogens and translocating them away from primary circulation. The pathogen is initially held in a state of "fullness," encapsulated in a blood capillary within the wei level on the surface of the skin. These have come to be known as "Longitudinal Luo" Vessels.
Blood, created by the Stomach, is allocated to the Luo Vessel to finance the "fullness." Eventually, taxation will result from the demands of the Luo Vessel: either through it's constant need for blood, or from latent heat generated from the stagnation. Blood will become insufficient, and unable to finance the Longitudinal Luo Vessel in its state of "fullness." The vessel will be forced to "empty" into the Primary Channel. At this point, another humor from the ying level, the thick-Ye fluids will come to support the latency. The Ye creates phlegm stagnation to prevent the pathogen from moving deeper into the Primary Channel. This manifests as lipomas, nodules and tumors along the Primary Channel, called "emptiness" of the Luo.
It is dangerous for the body to allow a pathogen to take residence in the Primary Channel because the Primary Channels connect to the Zang Fu. When a pathogen travels into the Zang Fu, it creates severe problems, threatening basic organic physiology. The body recognizes this danger, creating the safety measure known as latency to prevent a crisis.
When a pathogen empties from the Longitudinal Luo Vessel into the Primary Channel, it can be absorbed by the channel's source point, activating the "Transverse Luo" Vessel.
Pathology is usually transferred from the source point of the affected channel to the luo point of its yin/yang pair, where a new Longitudinal Luo Vessel is created. The pathology is held once again on the surface. However, when the new Luo Vessel also fails to maintain latency, it too will empty. As the original pair has already failed, the newly affected channel cannot translocate the pathology back to its partner.
After the Longitudinal Luo of both Yin/Yang pairs have emptied, the element's capacity to externalize pathology has failed. The channel has no choice but to absorb the pathology into its source point. This is when another aspect of the Transverse Luo becomes activated. Since the Primary Channel cannot create latency through externalizing the pathogen, it does so through internalizing it. Latency is created and maintained within the internal branches of the Primary Channels.
Any internalized pathogen transforms into heat, as established by Chapter 31 of the Su Wen. When wind or cold pathology enters the interior at Yang Ming, it transforms into heat. A similar situation occurs with the Transverse Luo. However, the type of heat generated by the Luo is Latent Heat.
The Transverse Luo are organized similar to Chapter 31 of the Su Wen. The Yang stages of the Transverse Luo mirror the progression described in the Su Wen. Yang Ming, representing the interior, attempts to vent latent heat back out to the exterior. Symptoms of the Yang Ming Transverse Luo are sweating, inflammation and dehydration. Latent heat can be vented to Shao Yang, manifesting in joint pain and sticky sweat; as well as Tai Yang in the form of head and sensory organ disturbances.
Taxation from latent heat will eventually lead to deficiency of yang qi, allowing transmission into the Yin Stages of the Transverse Luo.
According to the Nan Jing, excess creates deficiency, which allows for transmission. The theory of disease progression, presented by the Su Wen, is expanded upon by the Shang Han Lun. Consumption of Yang Qi from excess Yang stages of Tai Yang, Shao Yang and Yang Ming, give rise to the deficiency stages of Tai Yin, Shao Yin and Jue Yin.
Within the Yang stages of the Transverse Luo, the body still possesses sufficient Yang qi to externalize and vent latent heat smoldering in the interior. Taxation and ultimate consumption of qi allows movement into the Yin Stages, where symptoms are deficiency affecting the internal branches of the Primary Channels. Without adequate Yang qi to vent latent heat, it is left to consume and destroy the resources of the interior.
Consumption of qi and blood ultimately leads to damage to Yin and Yang. According to the Wen Being tradition, pathology that enters the blood level will impact yuan qi. Pathology moves from the Wei level into the qi level, representing the internalization of an external pathogen. Heat consumes post-natal qi and blood. Dampness attempts to slow down consumptive damage from heat. Eventually, pathology can penetrate into the blood level, where it impacts yuan qi. Blood supports Yin, and qi supports Yang. Damage to post-natal qi and blood creates lack of support for pre-natal resources, which can result in leakage, degeneration and rapid aging.
The Internal Pathways of the Primary Channels are dangerous places for pathology to be held. The Primary Channels connect with the Zang Fu. If there are adequate resources, the body will do whatever it can to keep pathology on the exterior, via the source/luo transfer of pathology. However, when pathology is unable to externalize, becoming stuck within the internal branches of the Channels, they are that much closer to the Zang Fu.
Five Element Theory, as presented in Chapters 50-54 of the Nan Jing, describes what happens to pathology lingering within the internal branches. The Yin source points connect to the Bladder Shu points via the Triple Heater mechanism. This is the physiological pathway that distributes essential qi from the Kidneys into the Primary Channels. The Bladder Shu points connect directly with the Zang. When pathology travels from the source point to the Bladder Shu point, it has access via the Control Cycle to all the other Zang organs in the body. Chapter 53 states "Seven transmissions of an illness skipping through the Five Elemental phases will result in death." Pathology traveling into the Zang is serious.
To prevent movement of pathology into the Zang, the body utilizes yet another set of channels. After the level of ying qi has failed to contain a pathogen, the yuan level steps in to absorb the problem. The channels associated with the yuan level are the Divergent Channels and the Extraordinary Vessels.
Chapter 27 of the Nan Jing describes the Extraordinary Vessels through mysterious, mythical language. The Nan Jing tells the mythical story of ancient sages, who wisely saved the world when it was besotted by flooding. They devised a plan to drain the catastrophic deluge by drilling holes into the rocks. The image of holes in the rocks is illustrated on the body through the Liao points, which are holes in the bones where pathology can drain into. When we are overwhelmed with "flooding" in our own lives, contending with wind that we cannot handle, the body can absorb the challenge into the yuan level. At the time of the Nei Jing, when pathology drained into the Extraordinary Vessels, it is was considered out of reach. It became the "seed" of the person's next incarnation.
The Divergent Channels also make the connection to the yuan level. However, they also link with the wei level, giving latent pathology the possibility for resolution. The Su Wen describes the Divergent Channels in Chapter 63. This is another "mysterious" chapter, that speaks about living in harmony with nature and the cosmos. These channels are unique in their connection between the deepest and most superficial levels of the body. Like the Primary Channels, they connect with the Zang Fu. However, the function of the Divergent Channels is to divert pathogens away from the Zang Fu into the joints where they are encased in Jing, and kept in a state of latency. The bones are expressions of yuan qi, as they are part of the skeletal system. They are also common areas of latency.
According to the Jia Yu Jing, the Gallbladder is the Fu that controls the marrow. Jeffrey Yuen defines marrow as Jing plus Shen: our essence and the spirit that motivates it. The level represented by Gallbladder is the last opportunity for intervention before pathology progresses beyond the reach of medical intervention. This is established by Chapter 11 of the Su Wen, and the discussion about the Primary Channels in Chapter 10 of the Ling Shu. Gallbladder is considered both a Zang Fu as well as a curious organ. It is classically seen as the bridge, allowing intervention into the pre-natal level.
The Divergent Channels indirectly connect to the curious organs, as they connect with the bones, which are themselves a curious organ. Arguably, working with the Divergent Channels, one can work with the marrow. The brain is called "the sea of marrow," considered a depository of consciousness and perception. My next article will discuss working via the yuan level with pathology that has gone into the Divergent Channels. Jeffrey Yuen has often said "the consciousness that created a disease cannot be the same consciousness that heals the disease." This statement resonates with that of Sun Si Miao, suggesting healing, especially from a very deep condition, may require a change in our perception of the world. This can be done through working with Gallbladder, the brain and the marrow.
Click here for more information about Nicholas Sieben, LAc.