Many people used to call vascular disease "the silent killer," because individuals had no knowledge of its accumulation until the fatal event occurred. We now have a much broader dissemination of knowledge and equipment to allow many more people to survive their acute crises, yet the insidious accumulations that create them remain.Pathological stagnations accumulate and substantiate without individuals being aware of the actual process.
This model of pathogenic factors accumulating in "dormancy" occurs in many diseases from osteoarthritis to cancer. While the symptomatic expressions of many diseases appear suddenly, the pathological processes that create them accumulate over a period of many years. Yet, the individual does not experience any physical distress, so they are not affecting the primary channels, which are responsible for the individual's moment-to-moment physiological and experiential process.
Pathogenic processes are frequently suspended from conscious awareness and displaced from the primary channels through the process of embodying them, making them somatic. They are embedded in physical humors and accumulate. While this process of displacing unresolved struggles can facilitate individuals in "getting on with it" in the short term, it also creates substantial challenges for the future. When the individual's capacity to suspend pathological factors is overwhelmed, they burst out in overt expression.
At that point, healing requires more than balancing or harmonizing the primary channels. Accurate primary channel treatments can relieve such symptoms for several hours, days or perhaps even weeks, but they re-emerge. They are based in accumulations of previously suspended material, which had been redirected out of the primary channels to allow the individual to maintain life by concentrating on new input. While the expression of distress can be mitigated by treatments focused on the primary channels, the accumulations that create that distress lie beyond their limits.
The theoretical framework presented in the ancient classics of Neijing provides an alternative. There are at least two centrally important features of Lingshu theory that have not been reflected in modern acupuncture theory and which address this issue:
- The profound meaning and importance of the "roots and nodes." The roots (of qi) lay on the extremities, and the nodes or terminations are on the torso. Modern theory seems to use this idea only to support its most important acupuncture points being located on the extremities, for treating the roots of qi. However, treating only on the extremities is criticized in Lingshu, which instructs that in addition to the extremities, one must also treat points along the central axis. The theory of roots and nodes actually suggests that while the urge and capacity to interact with the environment (through the extremities) elicits post-natal qi, it attaches and accumulates in the torso.
- The five sets of channels and vessels. [Note: I'm using "vessel" as a translation for luo, rather than the more standard "collateral" to emphasize their capacity to contain, and to remove the implication they are secondary. Since this word can also be translated into mai, the Qi Jing Ba Mai (Eight Extraordinary Vessels) become the fifth set of channels and vessels presented in Neijing.] Three of these five sets can contain accumulating pathogenic factors. They each have vital and interrelated roles in facilitating "normal" life, after the individual has engaged input that he or she cannot process to resolution.
As a source text, Neijing is the "Philosopher's Stone" of Chinese medicine. Sorting out its enigmas stimulates inspiration. Studying Neijing can progressively transform one's thinking from static differentiations toward reflecting the dynamic responsive nature of human life. Yet, this revered pair of classic texts is far from clear. Probing their depths invites, even requires, individuals to exercise, refine and deepen their capacity for clarity and insight.
Since the Song Dynasty (960-1279), Chinese medicine has increasingly focused on the primary channels. Its theoretical framework and diagnostic categories became syndromes of the zangfu, the vital and hollow organs. Each of the primary channels enters the organ for which it is named, as well as its "paired" organ, and in many cases one or more others. Thus, treating a primary channel can directly impact the organ for which it is named, and at least one other. Modern Chinese medicine focuses on the zangfu, and uses the primary channels as a way to impact them.
Modern practitioners appear to think that insidious pathologies accumulate in the organs, more specifically the zang (vital organs). The zang contain, while the fu (hollow organs) transport and do not contain. Thus, between these two, the zang are the only possible candidates for containing insidious (and accumulating) pathology. Yet, the zang contain the five ling (souls), which allow the individual to embody. During the classical period of the Western Han Dynasty (206 B.C. to 9 A.D.), when Neijing was recorded, people believed that stagnation in the zang directly compromised the individual's embodiment. They gave the function of containing pathogenic accumulations to the channels and vessels instead.
One could argue this theoretical point between Neijing and Nanjing, and various historical interpretations since those seminal texts were recorded. But, that really isn't the point of Chinese medicine. The point is effective treatment, and the key question here is: Are the primary channels the most effective way to treat people with ailments precipitated by overwhelming their beings' capacity to contain unresolved and suspended conflict? The classical answer to that question is frequently a resounding no!
Treating imbalances among the vital functions regulated by the primary channels can leave more resources to suspend conflicts that had been previously left unresolved. This is valuable when the individual doesn't have sufficient qi (or willingness) to release or expel accumulations. However, the classical approach, reinforced by the historical School of Purging and Elimination, suggests that if a person is able, the best path for healing stimulates the being to expel pathogenic stagnations.
The most direct way to expel pathological stagnations focuses treatment among the various reservoirs that contain unresolved and embodied conflicts in life. These are the divergent channels - the luo and the Daimai (Belt Vessel). The other extraordinary vessels can be stimulated to provide constitutional resources to facilitate more effective containment or expulsion of long unresolved pathogenic factors. The most effective treatments for many people with chronic and/or degenerative diseases derive from working with these channels and vessels to fundamentally transform the individual's habitual ways of accumulating unresolved material. This transformation is the alchemy of healing.
For more on the long history of modernizing influences in acupuncture theory, see "The Channels and Vessels of Acupuncture," which is available at www.daoistmedicine.com.
Click here for previous articles by Steven Alpern, LAc.