Eastern Perspectives

A page of the Huangdi Nejing

Now that we have reviewed a history of acupuncture, how exactly do the historical texts explain acupuncture and related concepts in traditional Chinese medicine (TCM)? To look into this question, I delved into the Huangdi Neijing (the Suwen and parts of the Lingshu) myself to see what I could unravel from the original text. I by no means am an expert, but translations and notes of the original text have helped me pick out basics of the practice.

Qi is one of the most basic concepts in TCM, yet one of the hardest to translate into a Western equivalent. Though it’s commonly and incorrectly understood to be some type of energy, it’s often used in TCM associated with states of matter. It can be represented in various forms, some seeming to be tangible (such as vital fluids or breath) and others essential as essence of a function. It is the flow and transformation of Qi that is most important in TCM, as the Qi requires balance in form and function and needs to flow equally into, throughout, and from all the body's systems.

As part of the balance, TCM employs the concepts of yin and yang and the five elements. The yin and yang represent balance through dialectic relationship in all things. If the yin is solid, then the yang is fluid and air; if the yin produces then yang is what is filled. Each is in balance and in opposition, but take away one and the other would not exist. Often it is an imbalance in this system of opposition that causes many of the illnesses in TCM: at its very basic level, most ailments are caused by an excess or lack of vital flow, developed through overproduction, underproduction, overfilling, blockage, or environmental effects.

The five Chinese elements also play a role, as Qi flows through the body in various states, each with elemental qualities. Elements must be in balance, so that there is not too much heat, cold, or dampness. Again, it’s a state of equilibrium and balance that is required and if one element becomes overpowering, it manifests in the form of an illness. For example, in the Neijing it states, "When wind and heat have harmed a person, then his nine orifices are shut and blocked. When fog and dampness have caused a disease, then a shade on the eyes obscures vision." There's also a balance between the elements and seasons as well. For example, it’s said in the Neijing that being exposed to the winter's cold causes a warmth disease as your body tries to produce heat for balance (i.e. you get feverish).

TCM also uses a system of organs, though the organs are similar to the ones presented in western medicine, but often their functions are different. For example, the Neijing says that the qi of the kidneys nourishes the bones and keeps the body strong. If the kidneys are weak, a person will grow tired and their bones will become brittle. Each organ is associated with yin or yang and each has an associated element as well. Qi flows through each, being stored, transformed, and transported throughout the body in many forms and for many functions. Each yin organ works with a yang, and each fits within a system of Qi flow. From what I understand, the actual thought behind the way the organs and Qi work are very similar to what we believe in Western medicine. Qi is taken in with food and air through the body (through organs like the lungs), transformed into other forms, and is used inside the body in various ways, and then eventually leaves as waste.

An image showing the channels in the hand

Now the interesting thing I found was that there is no system of meridians mentioned in the Suwen. There is reference to jing mai and lou mai, which are seen as a system of vessels that transport vital fluid within the body (like blood and forms of qi), but their descriptions in the Suwen (along with other types of small vessels) more accurately describe the circulatory system rather than some abstract system of energy flow. There are also some references in the Suwen describing early forms of acupuncture as being more akin to medieval bloodletting practices than modern acupuncture.

I had issues finding a copy of the Lingshu that wasn't completely turned into a modern textbook for acupuncture, but did manage to find partial copies that had been more or less directly translated. From what I saw, the Lingshu was more or less a diagnostic tool for every known illness. Once the cause of an illness was discovered a treatment could begin. For example, some types of fever were seen as both an excess of yang energy causing a heating of the exterior and insufficiency of yin, causing a heating of the interior. The recommended acupuncture points were a series meant to restore yin and cool inside, while causing sweating to release yang energy and cool the body.

Works Cited

The Yellow Emperor's Classic of Medicine. (1995). (M. Ni, Trans.) Boston: Shambhala.