Figure 92: CHENG DAN-AN (1899 -1957)
director of the institute of Acupuncture and Moxibustion, who perhaps played the leading role in codifying TCM theory and practice.
I wanted to include the development of “New Acupuncture” in China because it paralleled earlier developments in Japan where the government in 1918, favoring the Western scientific outlook, compiled a list of “revised acupuncture points,” which became the standard for licensure. The revised acupuncture points bore no resemblance to the traditional Meridians and Points, but were arbitrarily arranged according to a grid system superimposed over the surface of the body.(241) Naturally, this governmental decision provoked a reaction on the part of the proponents of traditional medicine, who in Japan had always been interested not only in the Chinese medical teachings, but also in their own spiritual tradition of Shinto, which as I have indicated was an early derivative of the form of shamanism that originally inspired the development of acupuncture in China and Korea. It is beyond the scope of this book to recount in detail the history of the development of acupuncture in Japan and the other countries of the Orient, or the struggles that were fought to preserve the purity of TOM, although I will have occasion to refer to it again. Suffice it to say that fortunately, classical TOM began to spread from China around the world at least as early as the Tang dynasty when it was transmitted to Japan, Korea and Vietnam.(242) Each of these countries developed its own style of acupuncture and Oriental medicine, and together with Taiwan and Hong Kong, preserved the parts of traditional acupuncture which later became unfashionable in China. Eventually, acupuncture spread to the West and today it is practiced, in one form or another, almost everywhere in the world. The final chapter presents my own attempts to recreate its journey to the West.
5
History as Mystery: Traditional Acupuncture’s Journey to the West
While the preceeding chapters have presented the history of acupuncture from a chronological standpoint, the present chapter will take a different tack. As I have indicated, it is not my intention to describe the development of all the various traditions of acupuncture to be found in the West, but rather to focus on one of them, LA, and to report the findings I have personally uncovered in digging for its roots on and off over the last twenty years.
Let me begin by pointing out that regardless of how it may be commonly portrayed, LA is essentially a syncretic style of acupuncture, meaning that it combines methods and ideas from a number, of different sources. I first realized the truth of this characterization in contemplating the integration of homeopathy into the syllabus of the Leamington College. Homeopathy is a non-conventional Western approach to medicine first developed in Germany in the nineteenth century, and as such could not have been part of any of the “classical” approaches to acupuncture or Oriental medicine. In fact, I do not know of any Oriental works that combine acupuncture and homeopathy, although as we shall see, there is a substantial precedent for such a combination in the West. I point this out because Worsley himself often says that what he teaches is the “traditional” or “classical” style of acupuncture transmitted to him via oral tradition by his teachers, and that they told him such teachings were handed down to them in this way from ancient times. This depiction of the purity of the classical teachings of LA must be taken with a grain of salt, for Worsley himself has also stated that he has personally tried every form of acupuncture currently being taught, including even the most clearly non-traditional method of electroacupuncture, and that he has formulated the syllabus of LA to include only what he has experienced as effective in promoting health of the Body, Mind and Spirit as a whole. This comment was made in the context of explaining why his students didn’t need to repeat all the experiments and blind-alleys he went down in his own development. Such an admission clearly supports the hypothesis of LA as a syncretic approach.(243)
By now, the reader should have at least a basic understanding of the major differences between what I have been calling TCM and LA. Official TCM textbooks were first written in the 1950’s–while the first comprehensive textbook of LA, on the other hand, has yet to be written! (244) I point this out for the following reason: Worsley, as I just said, claimed that LA was received by him as an oral tradition, and as such he has continued to transmit it to his students. If, however, we are to embark on a search for its roots, we must know what methods and doctrines LA uniquely includes, so as to identify any precedents. Lacking a text which could serve such a purpose, I have compiled the following list, which is not meant to be either exhaustive or officially approved; it is merely my own set of observations and I have keyed it to the theory of the Circle presented in Chapters One and Two.
ATTRIBUTES OF LA
1) BASIC PRINCIPLES: The universe (manifestation of the Dao) follows Natural Laws. Only by recognizing these Laws of Nature, and by following them in our practice of acupuncture can we treat safely and effectively. The most important of these Laws in LA is the Law of the Five Elements, along with its corollaries: the Law of Mother-Son and the Creative (Sheng) and Control (Ke) cycles. The Law of Yin and Yang is given less emphasis, but actually takes priority over the Law of Five Elements if it has been violated seriously enough to create a Husband/Wife imbalance (see number 5 below). The original unity of the Dao is reflected in the unity of Body, Mind and Spirit which can never be separated, although they represent sequentially deeper levels of human existence. The deeper the level of imbalance, the more serious the illness.
2) VITAL FUNCTIONS: The human organism is governed by twelve Officials who are responsible for maintaining and developing all aspects of our lives in health and in illness. Each of these Officials also exists on the levels of Body, Mind and Spirit. As long as the twelve Officials are allowed to function according to the Natural Laws, they will stay in balance with each other and we as a result will stay healthy. Only when one or more of the Officials is malfunctioning will we become susceptible to illness.
3) VITAL STRUCTURE: Each of the twelve Officials has a pathway called a Meridian, where its vital energy (Qi) flows. The Officials are linked directly to the internal branch of their related Meridians, while the external or surface branch is that portion of the Meridian along which are located the acupuncture Points. Treatment here can help restore normal functioning to Officials that have become imbalanced. Qi flows in a continuous cycle along these Meridians in a sequence that follows the Roman Numerals from I to XII, starting with the Heart, each Meridian experiencing a crest or waxing of its flow for two hours and a trough or waning of its flow for two hours every twenty-four hours. This cycle, reflecting the tides in the surface branches of the Meridians, is called the Wei or Protective cycle (as opposed to the deeper cycle of Qi flow according to the Five Elements) and the correlated two hourly peak for each Meridian is called the Law of Midday–Midnight. Each acupuncture Point has not only a traditional location (which may vary slightly in LA from the locations adopted in TCM) but also a traditional name which was chosen in antiquity to represent its therapeutic potential when stimulated in the appropriate circumstances. This energetic iconography is referred to in LA as the “Spirit of the Point.” In regard to the Eight Extraordinary Meridians and the other so-called “Secondary Meridians” such as Divergent, Tendinomuscular and Longitudinal Connecting Meridians, in LA only the Governing and Conception Vessels, which have their own Points are included. The use of the other Extraordinary and Secondary Meridians is felt to be ruled by a different “Patron” of treatment that is outside the scope of Five Element acupuncture. It is believed that Five Element treatment and the other special methods included in LA can achieve the same results, without needing to resort to these other Patrons which are part of a different tradition.
4) CAUSES OF DISEASE: Disease can occur only when one or more of the Officials is malfunctioning. This can occur as a result of either external or internal factors. The external factors are essentially the perverse climatic conditions while the internal factors are the extremes of emotiona
l trauma referred to earlier. Worsley teaches that within his own lifetime he has seen the predominant etiological mechanism change from the external factors when he was younger to the internal ones operative today when most people have adequate food, clothing and shelter, yet still get just as sick as did their grandparents. There is also a miscellaneous category of factors which relates to trauma, constitutional weaknesses, and above all, unhealthy lifestyles. These relate to diet, exercise, sexuality and other more spiritual aspects of life that will perforce lead to illness if they are not conducted according to the Laws of Nature by which we are all maintained.
5) DISEASE PROCESSES: Although all disease ultimately reflects malfunctioning Officials, the mechanisms preventing their normal functioning can vary. The simplest diseases occur when an Official becomes habitually overactive or underactive. Since all activity is dependent on the same Qi, usually when one Official is overactive (appropriating too much Qi) it will be at the expense of some other Official which, deprived of its normal share of Qi, will become underactive. This “normal” process of illness is the kind ideally suited to Five Element treatment, however there are other types of disease process which obstruct Five Element acupuncture from working properly, and in LA must be treated first. The simplest of these cases is the existence of a blockage in the flow of Qi along the Meridians. This blockage can be either between the left and right halves of a Meridian (called an Akabane imbalance), between one Meridian and the following Meridian along the “Wei circuit” (called an Entry-Exit block), or along the midline Extrameridians (called a GV-CV block). More serious kinds of disease mechanism that demand priority in treatment include Possession, Aggressive Energy (AE) and Husband/Wife imbalance (H/W). Possession describes a situation where the patient is no longer in control of his own Qi. It can be thought of either as a situation of being controlled by some outside force or “devil” or alternatively as one of being controlled by an internal compulsion or obsession–the important point is that an abnormal energetic pattern has taken over some level of the patient’s functioning–Body, Mind or Spirit. Serious cases of Possession can be found among patients classified as insane, but less severe examples can be found in people who can exist in society, without ever knowing what it is like to feel all right in themselves. Aggressive Energy, or AE is a polluted form of Qi that is poisoning one or more of the Officials. Again it can come from an external or an internal source, but as long as it is present, Five Element treatment is contraindicated, as it may spread this polluted energy. AE is both diagnosed and treated via the AEP’s (Back Shu Points). The final disease mechanism that can occur, a Husband/Wife imbalance, is felt to be the most dangerous. An H/W represents a situation where the patient’s own self-healing mechanisms are shutting down, reflecting a turning away from Natural Law. This usually occurs in response to a truly catastrophic situation in someone’s life, and it reflects a breakdown of the most fundamental Law of Yin/Yang balance. The H/W is diagnosed from the pulses, (those on the right wrist being excesive with respect to those on the left wrist) and treated by a protocol to re-establish Yin/Yang balance. A final aspect of disease process which is relatively unique to LA is the teaching that diseases evolve in a specific direction and sequence, and that in healing, the symptoms will temporarily reoccur in the reverse order. This is known as the “Law of Cure.”
6) CLINICAL EXAMINATION: Traditionally, examination entails four aspects: seeing, hearing (which in Chinese includes smelling), questioning and feeling. These are not unique to LA, but two aspects are: Firstly, all information to be gathered in the examination is felt to reflect the Elements or Officials whose state of health and balance is itself being examined, and secondly, examination findings are only considered to be reliable if the patient allows his true situation to be exposed. This can only occur if there is good rapport with the patient which builds on trust, thus developing rapport is the most consistently practiced examination skill in Leamington–not pulse diagnosis nor any of the other technical skills. The Five Element information of greatest value is the subtle color which appears on the temples and other areas of the face, the patient’s vocal quality and odor, and finally the emotion which predominates inappropriately when the patient is under stress. These four findings are called Color, Sound, Odor and Emotion, and are felt to be the only reliable basis for evaluating the cause of imbalance amongst the Five Elements. Although easily described in a single sentence, the skill involved in perceiving them accurately can take a lifetime to master, as they are both subtle reflections of energetic phenomena and also easily disguised by the social masks we all adopt in order to be seen in the “most favorable light.” Other details of the LA examination that are relatively unique include the method and interpretation of the radial artery twelve position pulse diagnosis, which is carried out while holding the patient’s hand to facilitate rapport, while the palpating hand uses only the very tips of the fingers held perpendicular to the artery. The volumes of the pulses at each of the positions (recorded as gradations of plus and minus) is learned first while the pulse qualities are considered to be material for post-graduate study. The changes in the pulse are of paramount importance in the conduct of the acupuncture treatment and so they will always be felt before and after each treatment and perhaps several times in between. Other specific areas for examination include the abdomen, musculoskeletal structure and heat sensitivity at the ends of the Meridians (Akabane test), but really every aspect of each patient’s being–from the way they walk to the color of their socks–is felt to express something about their inner selves, and is used diagnostically. Worsley at one time described teaching “diagnosis at a glance” by having his students watch passengers getting off railway trains and from this simple observation try to assess their Elemental state. A final detail about the LA asking or history taking process is that the important part is to write down the exact words of the patient, for it is often the manner of expression and not the content per se which is of most significance.
7) TRADITIONAL DIAGNOSIS: There is one primary aim in making an LA diagnosis and that is to correctly identify the Causative Factor or CF of the patient’s energetic imbalance. The CF is one of the Five Elements which has been damaged in its functioning to such a degree that it produces a constant state of imbalance which does not change over time. The CF is identified by Color, Sound, Odor and Emotion, and is the primary focus of acupuncture treatment, which is why LA is colloquially referred to as Five Element acupuncture. Having identified the CF, it is also important to identify the level of disease–is it primarily due to malfunction of the Body, the Mind or the Spirit? Knowing the level can provide the key to choosing the most effective points for treatment. In a similar way, knowing the imbalanced Element within the Element of the CF can also be useful, but is again considered to be a post-graduate issue. After identifying the CF, blocks and other special conditions such as Possession, AE and H/W must be identified. The remaining issue with regard to both diagnosis and treatment in LA is that it is not symptom oriented. This means that the nature of the symptom does not inform the LA practitioner about the energetic cause which created it, and therefore provides no rational guide to diagnosis or treatment. LA dogma states quite literally that any symptom can be caused by any one of the Five Elements and thus cannot help us understand the energetic mechanism at fault. This teaching is diametrically opposed to that of TCM which is specifically oriented towards interpreting and treating the symptoms.
8) TREATMENT: I like to call the method of transferring Qi from Meridians in Excess to those in Deficiency through the Five Element cycles and Command Points, the “Central Dogma” of LA. It is practically the first treatment principle taught in LA, but it is rarely encountered in other styles of acupuncture. LA treatment also makes use of other Command Points such as the Source and Horary Points which are felt to be the safest to use, and special Points used for their “Spirits” such as the “Windows of the Sky.” In general, the treatment is focussed on improving the functional sta
te of the Officials of the CF and this is usually done by transferring Qi into them or otherwise Tonifying them if they are Deficient, which is usually the case. In a minority of patients the treatment required will be Sedation or Dispersion, but this is governed by the findings on pulse diagnosis. Tonification is accomplished by a rapid needle technique that only takes a moment, while Sedation requires leaving the needles in place for from several minutes to an hour at times. Each treatment is different depending on the energetic diagnosis at the time, and usually Tonification is the method of choice to begin with and is preferentially applied on the patient’s left side, while Sedation is preferentially applied on the patient’s right side. Relatively few Points are used in each treatment which along with the forementioned aspects of technique differentiate LA from other styles of acupuncture. Contrarywise, some aspects of LA treatment are common in other styles: situations when treatment is forbidden (drunkenness, exhaustion, etc,), the use of First-Aid or Emergency Points, and other special Points such as the Seas and Oceans. There are two final comments I have about LA treatment. The first is that there is a special emphasis on treating the Heart Protector and Three Heater Officials which are felt to be almost universally imbalanced, even in patients who do not have the Fire Element as their CF. Finally, treatment in LA is not caried out with the needles alone, nor only with the accompanying techniques such as moxibustion, important as it is. Once again, the rapport established with the patient enables the practitioner to become a part of the treatment itself, and this aspect of therapy is emphasized. The practitioner is felt to be a “vehicle” through which the healing power of Nature can be re-introduced, and a good practitioner uses not only physical tools but also compassion and guidance to help his patients back on the road to health.
In the Footsteps of the Yellow Emperor Page 11