8. DEMONIC POSSESSION. One of the more striking differences between LA and TCM is in their handling of the subject of demonology. Demons constitute an etiological category which has been discussed in Chinese medical writings extending at least throughout China’s entire dynastic history. As pointed out in Unschuld-1, demonology formed an earlier stratum of medical though in China than did the systematic correspondence theories of Yin Yang and the Five Elements, which added a new layer of medical thought rather than replacing the earlier one. In Chapter Four of the text I have presented the hypothesis that acupuncture itself most likely originated from the exorcistic practices of the early shamans or wu. In Chen Yen’s tripartite etiological model, demonic possession belonged in the miscellaneous category, meaning it was neither an exogenous nor an endogenous cause of disease, strictly speaking, and Zhang Jie-bing enumerated demonology as the thirteenth medical specialty in his 1624 work, the Classic of Categories (Unschuld-1, p. 220). TCM, in adopting a materialist framework, naturally rejected the demonological aspects of traditional Chinese medical thought as mere superstition. LA, on the other hand, retained the category of demonic possession, indicating by this term a loss of control over one’s own energy or life-force, and interestingly, LA recapitulates the historical record by considering such possession to be a “block” which must be treated prior to applying Five Element or systematic correspondence types of acupuncture. See also the entry on Seven Dragons for Seven Devils.
9. AGGRESSIVE ENERGY. Like Demonic Possession, the term Aggressive Energy or AE exists in LA parlance, but not in TCM. Like Possession, AE constitutes a “block” precluding Five Element acupuncture treatment, and is considered a foreign type of energy that has become mixed in with the individual’s own normal energy. In Chapter Five I discussed the concept of AE and established that this term was coined by Jacques Lavier, one of Worsley’s teachers as a translation of the Chinese term xie qi ( ) more commonly translated as Perverse or Evil Qi (Lavier-3, pps. 155-164). Lavier’s unique teachings about xie qi apparently derive from an oral tradition in Taiwan based on the teachings of Liu Wan-su, who proposed that ultimately all forms of xie qi would transform to Fire. Lavier mentioned two methods of draining xie qi, only one of which was incorporated into LA. This method involves needling the Back Shu Points (called Associated Effect Points in LA) of the Zang Organs involved, and retaining the needles until all traces of erythema (Fire) have dissipated. Lavier’s second method involved draining xie qi from the Five Shu Points (Five Element Points in LA). While TCM does not describe Aggressive Energy as such, it does make an important distinction between Normal (Zheng Qi ) and Perverse (Xie Qi ) Energy. See the next entry for the different conceptions of Zheng and Xie Qi in LA and TCM.
10. THE NATURE OF EXCESS AND DEFICIENCY. TCM stipulates that Excess (shi ) refers to the state of preponderance of pathogenic factors (xie qi) while Deficiency (xu ) refers to the state of insufficiency of normal resistance (zheng qi ), so in TCM these terms are not commensurate (Essentials, p. 63). The closest parallel to this conceptualization in LA is that of Aggressive Energy (AE) which is something to be eliminated from the human body. What remains behind is considered to be Normal Energy, which may be Excess in certain Organs and Meridians, and simultaneously Deficient in others. In this second conceptualization of Excess and Deficiency, the two terms both refer to Normal Energy (hyperfunctioning and hypofunctioning), and are therefore commensurate. The primary treatment strategy in LA is thus to redistribute Energy from sites of Excess to those of Deficiency, rather than to drain or disperse it. These different interpretations of the pathological states of Excess and Deficiency are thus responsible for the radically different approaches to treatment found in TCM and LA. The only explicit discussion of these two different concepts of Excess and Deficiency in the Oriental literature, of which I am aware, occurs in Fukushima’s text, page 161, however it is likely that many further examples will turn up when a more significant percentage of the voluminous Oriental medical corpus has been translated. Other Japanese sources (e.g. Ohsawa-1, pp. 74-75) reflect an implicit understanding of this second concept of Excess and Deficiency (again reflecting the Japanese influence on LA, primarily through Schmidt, Munster and Ono) although it is also present, for example, in Soulie de Morant -1, p. 66.
11. HUSBAND-WIFE IMBALANCES. LA posits three major types of “block” or pathological states that must be treated before employing its more typical Five Element approach to treatment based on identification of the Causative Factor (see entry below). The first two types of “block” are Demonic Possession and Aggressive Energy, both of which have already been described as pathological states in which some “outside factor” is disrupting normal functioning. The third type of “block” is called a Husband-Wife imbalance (H/W), and it reflects a situation where the abnormal distribution of Excesses and Deficiencies of Normal Energy has created a breakdown in the operation of the very laws of nature (Yin Yang and Five Element) which sustain life. Thus the H/W is considered a fatal type of pathology if left untreated. An H/W is diagnosed when pulses on the left wrist are weaker overall than those on the right wrist, although it is said that the more important difference between the pulses on the two sides is qualitative rather than quantitative–the left side pulses being of poorer quality overall than the right side pulses. In traditional Chinese thought the left side is Yang (and therefore male) while the right side is Yin (and therefore female), and Chinese family life is markedly paternalistic, so this idea would seem self-evident to Chinese practitioners. Its first mention in the Western literature was in Soulié de Morant-2 (Volume II, Chapter VIII) where the following quotation from “Iang Ko-sienn” is given: “Weak husband, strong wife–thus there is destruction. Strong husband, weak wife–thus there is security. Ta Tch III p. 32V” Soulié de Morant did not advocate a specific protocol for treating this imbalance, but his close grouping of the Laws of Husband-Wife, Mother-Son and Midday-Midnight was clearly the original basis for the incorporation of these laws into LA, following their translation into English in Mann-1, pps. 101-107.
12. THE LAW OF MIDDAY-MIDNIGHT. In his chart of the Five Elements, Worsley cites this law immediately after that of Husband-Wife, just as had Mann. Soulié de Morant presented them in the opposite order, so it is easy to trace the line of thought from Soulié de Morant to Mann to Worsley. Neither Soulié de Morant nor Mann cited any classical references for this law, however, the Chinese Organ clock on which it is based is universally recognized in Oriental medicine–only the details of how to apply it vary. In essence it states that each Organ has a two hour time period during which it is most active, and an opposite two hour period twelve hours later during which it is least active. One might suspect pathology in one of the correlated Organs, at its zenith or nadir of activity, if a symptom recurs regularly at a given time. Midday-Midnight is a translation of Zi Wu ( ) which are the names (Earthly Branches) of the time periods from 11 p.m. to 1 a.m. and from 11 a.m. to 1 p.m. This term also appears in the phrase “zi wu liu zhu fa” which refers to biorhythmic methodology in general, and was probably what Soulié de Morant translated as “Law of Midday-Midnight.” Biorhythmic methods were a development of the theory of phase energetics cited in Chapter Four as becoming an important aspect of acupuncture theory at least as early as the Tang dynasty. Various Chinese and European traditions include protocols for using the Law of Midday-Midnight in formulating acupuncture treatments, but perhaps because these are based on balancing Yin and Yang rather than the Five Elements, they were not incorporated into LA. The influence of this law on LA is found, however, in the use of Horary Points and the Four Needle technique which will be discussed in separate entries.
13. ENTRY-EXIT BLOCK. I stated earlier that in LA there are three major types of block which preclude Five Element treatment: Possession, AE and H/W. In addition, there are “minor” types of blockage of the flow of Energy which may interfere with the efficacy of Five Element treatment, although they do not in themselves lead to progressive
deterioration or fatality if ignored—at worst they seem to dampen the efficacy of treatment, so that it may only be partially successful. The main example of this kind of block is called an Entry-Exit block. It is felt to represent a failure of communication or Energy flow from one Meridian to the next Meridian following the superficial or Wei circulation. There is no specific dogma concerning the etiology of Entry-Exit blocks, although the most commonly diagnosed one in LA, between the Liver and Lung Meridians, is frequently seen in patients who take medications that are detoxified or metabolized by the liver. These blocks are diagnosed by persistent imbalances on the pulse between two Organs that follow sequentially in the superficial circulation, in spite of seemingly appropriate treatment to harmonize them. A special class of Points called Entry Points and Exit Points is employed in treating such blocks. Although these Points are not mentioned in any English language TCM texts, their use was taught to Radha Thambirajah at the Shanghai Military Medical College in the 1960’s, and is also part of the Daoist lineage taught to Jeffrey Yuen. Their initial description in the West was in Niboyet-2 where they were associated with the biorhythmic methods or Zi Wu Liu Zhu Fa mentioned in the previous entry. Niboyet learned this approach from his unnamed Chinese teacher, and in turn was the source for its description in Mann-1, whence its incorporation into LA. Another type of “minor” block is that between or at the specific levels of Body, Mind and Spirit, which will be described in a separate entry.
14. THE LAW OF CURE. This dictum, a component of the LA syllabus, states that in the natural course of healing, patients may experience a recurrence of previous symptoms in a characteristic order–from deeper to more superficial, from above to below, from more vital to less vital Organs, and in the reverse order of their original appearance. There is no mention of the Law of Cure in TCM, as this law was formulated by the German-American physician, Constantin Hering, one of the guiding lights of homeopathic medicine in the nineteenth century. One may well ask how it became incorporated into the teachings of a school of traditional acupuncture. As recounted in Chapter Five, the original proponents of acupuncture in France, notably Soulié de Morant and de La Fuye were intrigued by the similarities between acupuncture and homeopathy, and actively tried to integrate them. Many of the later pioneers of acupuncture in England also had previous training in various branches of what is now called complementary medicine, including physiotherapy, naturopathy, osteopathy, herbalism and homeopathy. In fact, Worsley’s closest associate, at the time he founded his own college and formulated LA, was a homeopath, Malcolm Stemp. Other early faculty members were also trained in homeopathy, including Dick Van Buren who subsequently founded his own acupuncture college. At some point, their homeopathic convictions found their way into the Leamington syllabus. A related naturopathic principle, known as the healing crisis, is also taught as part of LA, but in this case the concept is frequently mentioned by Oriental practitioners, although it is not usually written about, and is not mentioned in TCM texts. A healing crisis involves a temporary, usually short-lived episode following treatment during which the presenting symptoms are increased in severity, following which they markedly decrease in severity for a more prolonged period. This phenomenon is commonly described by the saying, “You’ve got to get worse before you get better.” It was enunciated as a universal finding by Yoshimasu Todo in Japan during the eighteenth century (Ozaki, pps. 218-224), but in this case I would attribute its presence in LA as due to parallel development rather than to transmission of doctrine from Japan to England.
15. COLOR, SOUND, ODOR AND EMOTION. Traditionally, examination of a patient comprised four components: seeing, hearing (plus smelling) questioning and feeling. While all surviving traditions acknowledge this paradigm, they put it into practice with marked differences in emphasis and interpretation. In TCM for example, the main examination skills include observing the tongue, feeling the pulse, and eliciting the patient’s history in a ritualized manned based on Zhang Jie-bin’s “Song of the Ten Questions.” LA emphasizes its own set of examination skills which are described in the following four entries. The first one, “Color, sound, odor and emotion” is a mnemonic phrase used to remind the practitioner of the essential components of a Five Element diagnosis. Each of these four perceptual categories has five possible findings, so as to correlate with the Five Elements. This is admittedly an oversimplification, as there are, for example, many more than five colors that can be seen in examining patients, however, these can all be classified as subcategories of one of the five basic colors: red (or lack thereof), yellow, white, blue and green. The subcategories (for example, a yellowish shade of green) are interpreted as reflecting a deeper level of diagnosis, the Element within the Element (Earth within Wood in this case) to be described in a separate entry. Before elaborating on the details of how one determines the specific color, sound, odor and emotion present in a clinical setting, I should mention that these findings are the basis for diagnosing the Causative Factor or CF, which is also described in a separate entry.
The five colors may be seen on the patient’s face, principally on the temples and secondarily under the eyes, on the smile creases and around the mouth. These colors are subtle emanations, and not the frank skin tone we normally observe. Being energetic signals, the characteristic colors should intensify and fade as the patient fluctuates from moment to moment in the degree of stress on his major Elemental imbalance during the course of the examination–particularly the questioning phase. The associations of the colors with the Elements are standard throughout TOM with the following exceptions: Wood is associated with green in LA, but may be associated with either green or blue in other traditions. The original Chinese word qing ( ) includes both these colors, and some modern translators have chosen the term cyan to reflect this ambiguity. The other disputed color is the one associated with the Water Element. Most references specify black in contrast to the blue chosen in LA. Matsumoto and Birch, on page 96, in describing the Japanese Meridian Therapy tradition, note that both blue and black are associated with the Water Element which they ascribe to a reference in the Su Wen. In Ni’s translation of the Su Wen, Chapter 72 describes “a deep blue energy emanating from solid kidneys to the north.” Matsumoto and Birch also confirm many of the facial areas in which to notice these colors, as specified in LA, thus it is likely that this component of LA derives from Worsley’s Japanese sources previously cited.
The five sounds (specified in Su Wen Chapter 5) are shouting, laughing, singing, weeping and groaning, although there is considerable variation between different translators–true also for the odors and emotions. Like the five colors, these are all normal components of the fluctuating pattern of healthy speech, but under stress, the sound associated with the imbalanced Element becomes predominant. In a similar manner, the odor associated with the imbalanced Element (specified in Su Wen Chapter 4), also predominates, being either rancid, scorched, fragrant, rotten or putrid. Finally, the same is true for the associated emotion (specified in Su Wen Chapter 5) which in LA dogma would be anger, joy (or lack thereof), sympathy, grief or fear. The only major disagreement between LA dogma and other traditional schools would be in the emotion associated with the Earth Element. In LA it is sympathy, while in most other references it is given as a variation of either pensiveness or worry (Lu, p. 37; Matsumoto and Birch, p. 98; Hashimoto-1, p. 39). We can see how sympathy became enshrined in LA dogma by noting that prior authors who adopted this translation from the Su Wen included Veith (p. 119) originally and Mann-1 (p. 94) subsequently (presumably guided by Veith’s choice). Perusing the Five Element chart given by Mann, his text seems clearly to be the source for the terminology of color, sound, odor and emotion used in LA, much as it was the source for the various “Laws of the Five Elements” previously discussed. What is unique about LA in this regard is not the terminology, but the process by which these concepts are engaged. Although this process will be discussed under a separate entry as rapport, I will give a brief description of its appli
cation to the examination in what has become known as “emotion testing.” In order to bring out the patient’s color, sound, odor and emotion most clearly, the Element responsible must be under some degree of stress. This can be accomplished as the practitioner, while interacting with the patient during the interview and examination, creates emotionally challenging moments, and keenly observes the patient’s reactions. “Emotion testing” harkens back to Zhu Zhen-heng’s “living noose” style of treatment mentioned in Chapter Four, and suggests that Worsley’s methodology owes as much to his Chinese teachers as it does to those from Japan.
16. THE RADIAL PULSES. As described in Chapter Four, the assignments of Organs and Meridians to the twelve radial pulse positions differ in LA and TCM. These differences are summarized in Figure 63, which points out that the LA schema is based on the Nan Jing, considered to be of highest authority in the Japanese Five Element tradition. These Japanese schools are commonly referred to under two different names, the first being Meridian Therapy (Keiraku Chiryo) and the second being Pulse Diagnosis (Myakushin). In comparing methodologies, it is clear that the examination of the pulse in LA is Japanese in derivation. Unlike the Chinese procedure adopted in TCM, in LA the pulses are felt with the tips rather than the pads of the fingers applied perpendicularly as illustrated in Figure 126. This methodology was transmitted to Europe by Masae Hashimoto, whose clinical skills were then propagated by George Ohsawa, Heribert Schmidt, and Elza Munster. Worsley could have become acquainted with it through either Schmidt or Munster or another Myakushin teacher such as Ono. Another feature of the LA pulse examination that appears to be Japanese in origin is the procedure for classifying each of the twelve radial pulses by a “plus” or “minus” to designate its relative state of Excess or Deficiency. This methodology is described in Ohsawa-1 (p. 51) and was presumably reflective of Hashimoto’s teaching, of which Ohsawa’s writing is a record. A similar system for recording the gradations of Deficiency and Excess numerically on a scale from one to eight was described in Lawson-Wood (p. 26) whose book was written close to the time of his initial contact with Ohsawa (although this contact was reported as having begun the year after the book was written) and before his association with Worsley. Since this methodology is absent from the works of de La Fuye and Stiefvater (as far as I know) who were Lawson-Wood’s other sources, the most likely lineage would be through Ohsawa. The issue of establishing the origin of this system of recording pulses, which is part of LA, is important, because it is a necessary precondition for using the transfer methodology in treatment, a topic of great contention and mysterious lineage to be discussed in a subsequent entry.
In the Footsteps of the Yellow Emperor Page 25