A Manual of Acupuncture - Peter Deadman.pdf

A Manual of ACUPUNCTURE Peter Deadman & Mazi n Al-Khafaji with Kevin Baker J O U R N A L OF CHINESE M E D I C I N E PUBLICATIONS Main text Point location text Chinese translation Research into classical Chinese texts & commentaries Peter Deadman and Mazin Al-Khafaji Kevin Baker and Peter Deadman Maz...

A Manual of ACUPUNCTURE Peter Deadman & Mazi n Al-Khafaji with Kevin Baker J O U R N A L OF CHINESE M E D I C I N E PUBLICATIONS Main text Point location text Chinese translation Research into classical Chinese texts & commentaries Peter Deadman and Mazin Al-Khafaji Kevin Baker and Peter Deadman Mazin Al-Khafaji Mazin Al-Khafaji Book design John Chippindale, Peter Deadman and Simon Hedger A Hsiung Chen Marks Creative Consultants Barbara Loftus Peter Deadman and Kevin Baker Brush calligraphy Original illustrations Illustration commission and revision Illustrations adapted by Peter Deadman Printed by Sung In Printing America, Inc. O Copyright 2001 by Journal of Chinese Medicine Publications 22 Cromwell Road Hove East Sussex BN3 3EB England Fax : (+44) (0)1273-748588 e-mail : [email protected] website : http: / / www.jcm.co.uk First published 1998 by Journal of Chinese Medicine Publications Reprinted August 1998,January 1999,March2000, September 2001. ISBN 0 9510546 7 8 Distributed in North America by Eastland Press, 1240 Activity Drive, #D Vista, California 92083, USA All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers. The information given in this book is intended as a resource and guide to trained practitioners of acupuncture. It is not intended to substitute for such training and should not be considered to supplant the clinical judgement derivingfiom such training. Whilst evey effort has been made to include cautions with regard to acupuncture treatment, the authors cannot accept responsibility for any treatment advice or information ofered. CONTENTS Chapter Contents Acknowledgements Introduction The channels and collaterals Point categories Point selection methods Point location and needling The Lung channel The Large Intestine channel The Stomach channel The Spleen channel The Heart channel The Small Intestine channel The Bladder channel The Kidney channel The Pericardium channel The Sanjiao channel The Gall Bladder channel The Liver channel The Conception vessel The Governing vessel The Extraordinary points Body area illustrations Areas reached by the channels Chinese dynasties Bibliography Glossary of terminology Point names index Point indications index General index Point numbers index About the authors CHAPTER CONTENTS The channels and collaterals Point selection methods The functions of the channels Selecting local points The twelve primary channels The twelve divergent channels Selecting adjacent points The eight extraordinary vessels the Penetrating vessel Selecting proximal points the Girdling vessel the Yang Motility vessel the Yin Motility vessel the Yang Linking vessel the Yin linking vessel The Luo-connecting channels The twelve sinew channels The minute collaterals The twelve cutaneous regions Point categories The five shu points the jing-well points the ying-spring points the shu-stream points the jing-river points the he-sea points The five phase points The xi-cleft points Selecting distal points Selecting points from below to treat above Selecting points from above to treat below Selecting points from the front to treat the back Selecting points from the centre to treat the extremities Selecting points from one channel to treat its interiorly-exteriorly related channel Selecting points from one pair of the six channels to treat disease of the other Selecting points according to channel connections Cross needling Selecting empirical points The chain and lock point association method Alternating points Point combinations Point location and needling The yuan-source points Cun measurements The luo-connecting points Needling The back-shu points depth of needling The front-mu points The hui-meeting points avoidance of pneumothorax needling the abdomen needling close to major organs The confluent points of the illustration of the location of major organs eight extraordinary channels needling close to major blood vessels needling close to major nerves Ma Dan-yang's heavenly star points The four and six command points Surface anatomy The points of the four seas The points of the window of heaven how to locate and count the ribs The thirteen ghost points of Sun Si-miao how to locate C7 how to locate L3 and L5 The nine needles for returning the yang how to locate the sacral foramina Chart of the meeting points of more than one channel 0 how to locate the sternocostal angle palmaris longus The Lung channel major points of the lateral forearm major points of the medial forearm The Large Intestine channel major points of the hand (dorsum) The Stomach channel major points of the chest major points of the hand (palm) major points of the upper abdomen The Spleen channel major points of the lower abdomen The Heart channel major points of the upper back major points of the lower back The Small Intestine channel major points of the back (Governing vessel and Bladder channel) major points of the anterior thigh The Bladder channel major points of the anterior lower leg major points of the lateral lower leg The Kidney channel major points of the medial lower leg The Pericardium channel major points of the medial foot major points of the lateral foot major points of the top of the foot The Sanjiao channel Areas reached by the channels The Gall Bladder channel Appendices The Liver channel The Conception vessel The Governing vessel The Extraordinary points Chinese dynasties Bibliography Glossary of terminology Indexes Point names index Point indications index General index Point numbers index Body area illustrations major points of the eye region major points of the face major points of the side of the head major points of the top of the head major points of the back of the head major points of the neck region major points of the shoulder region major points of the upper arm About the authors ACKNOWLEDGEMENTS PETER D E A D M A N dedicates this book to his family, especially Jenny, Susie, Natasha and Noah and to his grandfather Professor Shmuel Eisenstadt, who died before he could complete his encyclopaedic dictionary of Hebrew Law. M A Z l N AL-KHAFAJI dedicates this book to Pia Maria, Nadeem, Dina and Samir. KEVIN BAKER dedicates this book to his parents Mary and Tony. With thanks to : Tim Martin, who gave considerable assistance in the early stages of this book, Pia Maria Al-Khafaji, Fatima Bailey, Richard Blackwell, Shwu Ling Chern, Peter Eaton, Marian Fixler, Heiner Fruehauf, Oliver Hickey, Giovanni Maciocia, John O'Connor, Jacob Stevens, Rebecca Wilton, Allegra Wint. INTRODUCTION This book is deeply rooted in the classical tradition of Chinese acupuncture. The practice of acupuncture has grown spectacularly in the Western world over the last three or four decades. During the early period of this expansion there was scanty source material available. China was firmly closed to access by students of Chinese medicine, few textbooks were available in translation, and even fewer translators were skilled in the difficult task of rendering the terminology of Chinese medicine into other languages. As a result of these difficultiesit was not easy to gain an understanding of the genuine and varied classical traditions of acupuncture, and there was inevitably a great deal of misunderstanding and much necessary invention to fill the gaps. In addition to these factors, acupuncture is a forgiving and extremely flexible science. The insertion of a needle into the body in order to contact the qi will usually produce some changes, whichever the points selected. In current practice throughout the world, there is enormous variety in point selection. Indeed this 'fuzziness' is not confined to the Western world. Within modern and classical Chinese traditions there is also enormous variation in understanding and predicting the effects of needling different points, and a great variety of ways of treating different diseases. Such variation in practice calls into question the idea that there are any universally agreed criteria for choosing points. This is a disturbing thought, especially in an age and a culture that calls for certainty, and is one that cannot be considered at length in these pages. It is our belief, however, that the nearest thing to an objective body of theoretical and clinical knowledge is found within the Chinese classical tradition. This is largely because it represents the slow accretion of observation, recording and testing over a largely unbroken period of over twenty centuries (surely one of the most remarkable recorded historical traditions in world medicine).Many of the texts used and referred to in this book, for example the Systematic Classic of Acupuncture and Moxibustion and the Great Compendium of Acupuncture and Moxibustion were largely a record of the clinical practice of their day. Each of these great encyclopaedic compilations carried forward the theory and practice of earlier works, yet added, modified and crafted them according to the practice of contemporary physicians. This is most clearly seen in the classical point prescriptions, many of which are recorded in this book. Some date back to the Yellow Emperor's Inner Classic and are found repeated through later compilations. Yet they often show modifications, for example the addition or subtraction of points and even the purpose for which they are used. It is not our intention to present this traditional practice as cast in stone, as unchangeable, holy writ. The rapid development of acupuncture both within and outside China over the last few decades has itself led to great innovation in praktice, and this is very much borne in mind in discussing the points. Furthermore, the enquiring and challenging nature of the modern Western mind can serve to dispel some of the rigid restraints of tradition, discarding what is not helpful and introducing new practice and perspective. It remains the case, however, that the historical tradition of Chinese acupuncture, this unique record of changing practice over two millennia, should serve as the foundation from which we work and develop. Translation As anyone who has attempted to translate from classical (and therefore often archaic) Chinese knows, the task is fraught with difficulty.There is much debate at present on how best to convey the meaning of many difficult terms and concepts found within traditional Chinese medicine. Like everyone else we have wrestled with these problems and have made the following decisions: i. We have retained some Chinese (pinyin) terms which we feel are widely known, for example qi, yin, yang, jiao, Sanjiao, taiyang, yangming, shaoyang, taiyin, shaoyin, jueyin. We have kept these to a minimum, and the meaning of these terms is given in the glossary or within the text in case readers are not familiar with them. In some cases we have retained the Chinese term because there is not really any easy English alternative. Shan disorder, for example, is sometimes translated as hernia-like disorder in English texts. Hernia, however, only conveys one of three possible meanings of this term (see glossary). ii. In translating the majority of terms, we have carefully consulted a variety of previous English translations and selected those renderings that seem to best convey the original meaning, yet are relatively easy to use in daily practice. Examples of these include atrophy disorder for lwei zheng', painful obstruction for 'bi zheng' etc. We have also frequently stayed with terminology that is well known in order to make the text easier to read, for example we refer to the 'descending and dispersing' function of the Lung rather than recent alternativessuch as 'depurative downbearing'. iii. In many cases there does not seem to be any alternative but to adopt relatively new and unfamiliar terminology. This is especially the case with many of the indications of the points. Quite a few of these may be unfamiliar to most readers, for example sudden turmoil disorder, shan disorder, wind-taxationcoughing, cold inversion, Lung atrophy etc. Although we recognise that this may present a steep learning curve for some readers, we feel that it is important to include these terms. Sudden turmoil disorder, for ex2111rtlo yLb,r??;crhtha -- franS12tefl2s C~f)!Pr2, bUr p 2 u x J7 y- p f p v q- clear patterns of disharmony that can be summarised into point actions. Generalising the information in this way helps to clarify the welter of indications and simplify the learning process. It is not intended to replace a deeper study of the indications and influence of the points but rather to assist and complement it. to a wider variety of clinical situations where acute vomiting and diarrhoea present together, for example food poisoning. The simple fact is that disease description in classical Chinese texts is often different from a modern Western model, and yet may accurately convey clinical reality. In other words these terms are not just retained for reasons of historical accuracy. We hope that with continued use of this text and its glossary, many of these terms will in time become familiar. iv. On occasions we have included purely Western medical terms. Hypertension, for example, has no equivalent in traditional Chinese medicine, and yet several acupuncture points have a demonstrable effect in reducing blood pressure. We have used the term erysipelas in place of the literal Chinese 'cinnabar toxin' as the meanings of the two terms are virtually identical. v. As far as longer translated passages are concerned, the meaning of ancient texts written in classical Chinese is invariably open to some interpretation. We have consulted whichever commentaries are available and have generally chosen the most easily readable rendering. The point indications The majority of the indications given in this text are taken from classical sources. Whilst not exhaustive, we have chosen to list them in greater number than most English texts. It is our observation that the more indications there are, the easier it is to form an impression of the nature and forte of each point. It is clear, also, that the recorded indications for the points represent an important record of clinical observation that is at least in part empirical rather than theoretical. In order to make the indications easier to absorb, we have chosen to group them according to type, and it should be stressed that these groupings are our own and are not found in classical texts. The indications listed are not exclusively classicalhowever. We have added modern indications when these clearly reflect current clinical practice. For example Zulinqi GB-41 is much used by contemporary doctors for onesided headache, particularlyin combinationwith Waiguan SJ-5 and especially for headaches associated with the menstrual cycle, despite the fact that all major classical references are to occipital pain, and pain of the vertex. Finally we would like to stress that we have generally avoided adding indications to points when these are not listed in classical or modern Chinese texts. There has been a great deal of free interpretationin Western acupuncture, often based on supposition rather than either historical provenance or careful and lengthy clinical observation. One example of this process may be found with a point such as Shaofu HE-8. As the fire point of the Heart channel it is natural to assume that it clears Heart fire and thus that it would be indicated for disorders such as insomnia, mental agitation, sores in the mouth etc. and this is the impression given in a number of modern Western acupuncture books. In fact these indications are not found in classical Chinese texts and rarely in modern ones, and it is Laogong P-8 that has rather been used for these disorders. This is not to state categorically that Shaofu HE-8 does not have the ability to treat these disorders, only that it does not seem to have been used for this purpose. Our priority, therefore, has been to emphasise the historical records, not because we reject innovation and development, but rather because with a tradition as lengthy and unique as that of Chinese medicine, it is important first to establish what the tradition actually is, so as to innovate with care and respect. AxLAbu. ---* The point actions In general, it can be said that the ascribing of actions to acupuncture points is a modern (i.e. 20th century) practice, and one that draws from the Chineseherbal medicine tradition. Having said this, there is clear evidence of this practice in early texts. Among many examples, the Systematic Classic of Acupuncture andMoxibustion recommends Shangjuxu ST-37for 'heat in the intestine' and the Sagelike Prescriptions from the Taiping Era recommends the same point for 'insufficiency of large intestine qi'. According to the Essential Questions Xiajuxu ST-39'clears Stomachheat', whilst the Great Compendium of Acupuncture and Moxibustion recommends Sanyinjiao SP-6 for 'Spleen and Stomach deficiency'. Furthermore, in most cases ascribing actions to points is simply pragmatic. For example since Yinbai SP-1 is classically indicated for uterine bleeding, menorrhagia, blood in the urine, blood in the stool, vomiting blood, nosebleed and febrile disease with nosebleed, it is clear that it has the action of stopping bleeding. Lieque LU-7 is indicated for chills and fever and nasal congestion and discharge, and has clearly long been considered effective to release the exterior. Even a cursory examination of the classicalindications of most points reveals such The commentaries The actions and indications of the points can be found in many acupuncture books. What has been lacking is a systematic attempt to clarify and explain how the point has been used through time and how we might better understand its range of actions and indications. In the commentaries on the major points we have endeavoured to draw together and elucidate a great range of information. This includes the major classical and modern indications, the classical combinations in which the point appears, commentaries on the points in a variety of texts, the point's location and its relationship to various channel pathways, the point's status (for example as a xi-cleft or jing-well point), the phase (accordingto five phase theory) to which it is ascribed etc. Having considered all these factors we have finally added our own interpretation and experience as practitioners of long standing. Interpretation necessarily requires making judgements, and we have tried to balance our own original contribution with respect for the available information. There are many different traditional theories that can determine point selection. It could be, statistically-speaking, that the most commonlypractised method throughout the world is the needling of acupuncture points simply because they are tender i.e. ahshi points. At a more complex level are five phase theory, five shu point theory, the theory of the back-shu and front-mu points, the combination of luo-connecting and yuan-source points and so on. Between these different theories, however, we often find major contradictions. Which of these theories will we try to apply, and how do we approach the contradictions? Some practitioners, favouring one particular theory, are happy to apply it in an absolute sense. Thus a close adherent of five phase theory might in all cases select a 'mother' point to tonify a particular channel and a 'child' point to reduce it. How can we determine whether the abstract application of a particular theory like this, as though it is always appropriate, can be supported? For example, Quchi L.1.-11 is the earth and hence 'mother' point of the Large Intestine channel, and should therefore have a reinforcing function. How do we then accommodate the fact that whilst indeed it is an important point to tonify qi and blood in the upper limb, it is otherwise used to drain excess heat, fire, wind and damp from the body as a whole, not to mention the fact that its recorded indications include very few intestinal disorders. Similarly, according to five phase theory, Jiexi ST-41 as the fire point of the earth Stomach channelshould have a tonifying action, whereas all the recorded indications suggest it is used to reduce excess heat in both the Stomach channel and the Stomach fu. As far as the five shu points are concerned, the Classic of Difficulties in the 68th Difficulty states that jing-river points should be needled for dyspnoea, cough, chills and fever. Should we take this to mean that all jing-river points have this effect, or that in these situations we should always needle the jing-river points? How do we combine this with the statement in the Spivitual Pivot that jing-river points should be needled in the late summer or for changes in the patient's voice? Or what of the Spiritual Pivot classification of the relative state of the qi and blood in the six channels? Yangming channel, for example, is abundant in qi and blood, and this theory is frequently called upon to explain the use of the Large Intestine qnd Stomach yangming channels in the treatment of atrophy disorder and painful obstruction. The Spivitual Pivot also states that taiyang and jueyin channels are abundant in blood, which helps to explain why points such as Weizhong BL-40 and Quze P-3 may be bled to clear heat from the body. What then of the contradictory clinical application of bleeding Shaoshang LU-11 in cases of sore throat, when the Spivi t z d Pivot states that taiyin channel is abundant in qi but not in blood? Throughout the history of Chinese medicine, different theories have been developed, tested, contested, retained where useful and quietly dropped when not, and commonly kept in part when considered clinically or theoreticallyvaluable. No matter that the theoreticalbody of acupuncture may contain contradictory theories. In certain situations one theory may be held to apply, in others not. In our commentaries on the points we have attempted to sift through these various theories and find those most relevant to understanding and explaining how a point has actually been used and tested in clinical practice, the final arbiter of such discussions. The point combinations The majority of the point combinations listed under each point in this book are taken from classical sources, and these are given in parentheses. We have taken the liberty of changing the order of the points listed so that the same combination will appear several times throughout the text, under different points listed in the combination. A small proportion of the combinations are modern, some taken from contemporary Chinese sources and some from our own clinical experience. In these cases no source is given. Capitalisation We have tried to keep capitalisation of words to a minimum. However we have kept the names of the zangfu (Lung, Stomach, Heart etc.) capitalised to distinguish them from the Western medicine names of the organs (lung, stomach, heart etc.) Point locations The locationsgiven in this text are derived from a comprehensive review of the modern Chinese renderings of traditional sources, informed by the authors' clinical experience.We have made every effort to be as anatomically precise as possible and thus resolve the contradictions '7 nmnC;-,>c L3WIILLLIIILC.D C n x 3 n ,-I ;n I V U L L U 211 nv; e + rr ~7ni-i-rlnpQ+ifii? Jncpyin+-innc L / \ L U C l l l b Y V I I L L I V L U C I V I I U b U L I L r """"' Where there are in effect two alternative locations for a point this is clearly described in the text. The precision of anatomical description however does not relieve the practitioner of the responsibility for careful observation and palpation of the area to be needled so that relevant underlying structures such as blood vessels are protected and the fundamental importance of the role of palpation in point location is not neglected. Location notes These notes are derived from the authors' clinical experience taken together with the traditional sources. They are simply intended to facilitate the practitioner's ease of location of points in clinical practice. Need ling The practitioner must remain aware that acupuncture is an invasive therapeutic procedure. The needling instructions given are intended to highlight the aspect of safety at least as much as that of therapeutic efficacy. To this end throughout the text specific cautions concerning the use of potentially harmful acupuncture points are clearly given. Extra points We have utilised the numbering system used in Acupuncture: A Comprehensive Text1. Errors Every attempt has been made to reduce errors in this text. Such is the nature of human existence, however, that mistakes are unavoidable. In the interests of improving future editions, the authors would be grateful to have their mistakes pointed out. Notes 1 Actrptr~zctureA CoinprelzensiveText, ShanghaiCollegeof Traditional Medicine, translated and edited by John O'Connor and Dan Bensky, Eastland Press 1981. The channels and collaterals THE CHANNELS A N D COLLATERALS "It is by virtue of the twelve channels that human life exists, that disease arises, that human beings canbe treated and illness cured. The twelve channels are where beginners start and masters end. To beginners it seems easy; the masters know how difficult it is". "Qi cannot travel without a path, just as water flows or the sun and moon orbit without rest. So do the yin vessels nourish the zang and the yang vessels nourish the fu". Spiritual Pivot Chapter 17. Spiritual Pivot Chapter 17. INTRODUCTION 'Channels and collaterals' is a translation of the Chinese term 'jingluo'. 'Jing' has a geographical connotation and means a channel (e.g. a water channel) or longitude. In this book it is translated as 'channels', elsewhere as 'meridians'. Using the image of a tree, the 'jing' are like the trunk and main branches of the channel network. They generally run longitudinally through the body at a relatively deep level, and connect with the internal zangfu. Specifically they comprise the twelve primary channels, the eight extraordinary vessels and the twelve divergent channels. 'Luo' means 'to attach' or 'a net', and refers to the finer branches of the channel network which are more superficial and interconnect the trunk and main branches (jing), the connective tissues and cutaneous regions. In this book they are referred to in general as the collaterals, and more specifically as the luo-connecting channels. There are fifteen luo-connectingchannels, the twelve that belong to the twelve primary channels, the luo-connecting channels of the Conception and Governing vessels, and the great luo-connecting channel of the Spleen. The general category of the collaterals also includes the myriad 'minute' collaterals that are distributed throughout the body. In addition to the jing and luo, there are twelve sinew channels and twelve cutaneous regions. Whilst a typical chart of the acupuncture channels, therefore, illustrates only the superficial pathways of the twelve primary channels, we should remember that the channel network is considerably more complex than this, and there is no part of the body, no kind of tissue, no single cell, that is not supplied by the channels. Like a tree, the trunk and mainbranches define the main structure, whilst ever finer branches, twigs and leaves spread out to every part. The study of the channels in traditional Chinese medicine can be said to be the equivalent of the study of anatomy in Western medicine. Chinese medicine paid scant attention to the physical structure of the interior of the body, and references to the shape and location of the internal zangfu in classical texts are few and very brief. Furthermore there was no study of the distribution of the nerves, or the origin and insertion of the muscles. Traditional Chinese medicine did, however, describe in minute detail the pathways of the wide variety of channels that serve to circulate the qi and blood to every part of the body. The channels penetrate the zangfu and the extraordinary fu in the deepest levels of the body and connect with the skin, muscles, flesh, tendons, and bones, the head, body and limbs, and the sense organs, linking all the tissues and structures of the body into an integrated whole. HISTORY OF CHANNEL THEORY Different theories have been advanced to explain the discovery of the channels. These theories may be summarised as being of two main kinds: i. points first, channels second, and ii. channels first, points second. According to the first theory, centuries of observation of the existence of tender spots on the body during the course of disease, and the alleviation of symptoms when they were stimulated by massage or heat, led to the gradual discovery of the acupuncture points. When sufficient points were known, they were linked into groups with common characteristics and effects, and aided by the observationof propagated sensation when they were stimulated, understanding of channel pathways followed. According to the second theory, propagated sensation during the course of massage and more especially the exploration of the internal landscape of the body through mediation and qigong practice, led to the discovery of the channel pathways, with the knowledge of specific points coming later. This second theory received strong confirmation from the significant discovery of a silk book during excavation of the Western Han tomb at Mawangduil, which describes the pathways of eleven channels but does not refer to any specific points. The channels and collaterals THE FUNCTIONS OF THE CHANNELS 1 Transporting qi and blood throughout the body and rendering the body an integrated whole It is by virtue of the complex interweaving network of the channels that the qi and blood is transported to every part T P the ~ b d y. AII the mgarrs, sense q p n s and tissl-IPSare nourished, energised and warmed by the qi and blood circulating through the channel network. Using the analogy of a plant, the zangfu may be perceived as the roots of the channels, the channels themselves as the stems, and the different body tissues, and especially the sense organs, as the flowers. Thus the Heart, for example, is said to 'flower' into the tongue. The zangfu, the channels passing through the limbs and body, and the tissues and sense organs which they nourish therefore constitute an integrated whole. At the same time, by virtue of the interconnections between the channels, the zangfu themselves are linked with each other. For example, the primary channel of the Lung originates in the Stomach, and passes through the Large Intestine and diaphragm, whilst the primary channel of the Heart connects with the Small Intestine and Lung. By virtue of their origin in the depths of the body and their emergence at the surface, the channels also link the interior with the exterior. Since they run bilaterally, or in the case of the Girdling vessel encircle the body, the primary, divergent, connecting and sinew channels as well as six of the extraordinary vessels, link the two sides of the body, and since they run vertically, the various channels link above with below. The theory of the channels, therefore, underlies one of the most significant discoveries of Chinese medicine; they form the physiological interconnectionsthat render the body an integrated whole rather than a series of independent units. 2 Protecting the body "When the pathogen comes to dwell as a guest, first it resides in the skin and body hair. If it remains and does not leave it will enter the minute connecting channels. If it remains and does not leave it will enter the luo-connecting channels. If it remains and does not leave it will enter the channels, reaching the five zang and spreading into the intestines and Stomach Essential Questions2. The various kinds of channels different depths within the body. As well as nourishing and energising these different layers of the body, the channels serve to prevent the penetration of pathogenic factors that may Most superficial Cutaneous regions Minute collaterals Sinew channels Luo-connecting channels Prima-\/ r h ~ n n ~ l c I -..-....-.- Divergent channels Extraordinary channels Deep pathways of the primary and divergent channels Deepest attack the body from the outside. Wind, cold, damp, heat, fire and dryness are important causes of diseas,eaccording to Chinese medicine. When extreme, or when the body resistance is lowered, they can attack the body and easily penetrate to the deeper levels such as.the zangfu and the bones and joints. The deeper the penetration towards the zangfu, the more serious the disease becomes. Part of the function of the channel network is to contain and repel these pathogenic factors, and prevent deeper penetration. Thus, for example, a person who sleeps in a draught may wake with a stiff and painful neck. The wind and cold will usually in this instance have injured only the more superficial portions of the channel network, i.e. the sinew channels, causing local stagnation of qi and blood. Treatment, whether by acupuncture, cupping or massage will relatively easily eliminate the pathogenic factor. If, however, a person is frequently exposed to wind, cold and damp, then over time the pathogenic factors will not be contained at the level of the superficial channels, but may penetrate deeper into the body, injuring the joints, sinews and bones. If even more prolonged, the pathogens may injure and weaken the zangfu, most commonly the Liver and Kidneys. Alternatively, an acute attack of wind and cold may induce the typical symptoms of chills, slight fever, headache, body aches, runny nose etc. Here, the pathogenic factors have injured and caused stagnation of the defensive and nutritive qi in the relatively superficialportion of the body. The treatment principle is to release the exterior. If, however, the pathogenic factors are not contained at the superficial level, but penetrate deeper, they may injure the zangfu, most commonly the Lung, Stomach, Spleen or intestines. To summarise, the entire channel network serves as a series of barriers to prevent the deeper penetration of pathogenic factors from the exterior. When contained at the exterior,the disease is relatively less serious and easier to eliminate. When the body resistance is lowered, or the The channels and collaterals pathogenic factor is exceptionally strong or prblonged, and the channels cannot contain the pathogenic factors at the exterior, the disease is relatively more serious and harder to cure. 3 Responding t o dysfunction in the body When the harmony of the body is disrupted by any of the causes of disease, the channels can respond in a number of ways: i. Disease of the channels themselves The channels themselves can be diseased giving rise to local tenderness, pain, weakness, distention, numbness, tingling etc. Disease of the channels means impaired flow of qi and blood (i.e. stagnation) or insufficiency of qi and blood leading to malnourishment. For example: back sprain due to traumatic injury can give rise to pain, aching, tingling etc. in the channels in the lumbar region and leg. attack by pathogenic wind and cold into the muscle layers can give rise to stiffness, soreness and aching with points of local tenderness, whether acupuncture points or ahshi3points. prolonged exposure to wind-cold-damp may give rise to chronic pain and aching in the limbs and joints. previous injury or prolonged over-use of any part of the body may give rise either to stagnation or deficiency in the channels in a local area resulting in aching and pain. Disease of the zangfu reflecting onto the channels When the zangfu are in disharmony internally, their related channels may also show signs of disorder, for example: stasis of Heart blood can give rise to pain which descends along the Heart channel in the arm, or ascends along the Heart channel to the throat. stagnation of Liver qi can lead to distention and pain in any portion of the Liver channel, or its interiorlyexteriorly related Gall Bladder channel, for example the genitals, lateral costal region, breasts, throat or head. Heat in the Stomach fu may give rise to symptoms such as excessive hunger and vomiting as well as transmitting to the Stomach channel in the head, giving rise to tooth abscess, bleeding gums, ulcers on the tongue etc. Liver fire can transmit via the Liver channel to the eyes and manifest as redness, soreness and pain. 13 iii. Disease transmitting via the channels Disease can pass from one zangfu to another via the channels, or from one channel to another, for example: Heart fire can transmit from the Heart channel to its interiorly-exteriorly related hand Small Intestine channel, from the hand taiyang Small Intestine channel to the foot taiyang Bladder channel and thence to the Bladder fu. severe deficiency of Kidney yang and impaired transformation of body fluids can cause excessive water to overflow to the Lung and/or Heart, both linked to the Kidney via the internal pathway of its primary channel. zv. Visibly showing disease In some cases, the course of a diseased channel can be discoloured and therefore visible, whether purple showing stasis of blood, red indicating heat, or pale as a result of deficiency of qi and blood. 4 The channels serve t o transmit qi t o the diseased area The channels serve to transmit acupuncture stimulation from the acupuncture point to the diseased area of the body, rendering acupuncture treatment effective. By stimulating an acupuncture point by some means, whether by needling, application of heat, pressure, massage or cupping, the qi and blood of the whole course of the channel may be regulated. THE TWELVE PRIMARY CHANNELS GENERAL DESCRIPTION There are twelve primary channels running vertically, bilaterally, and symmetrically.Each channel corresponds to, and connects internally with, one of the twelve zangfu. The channels corresponding to the zang are yin, and the channels corresponding to the fu are yang. There are therefore six yin and six yang channels, three yin channels and three yang channels on the arm, and three yin channels and three yang channels on the leg. To understand the pathways of the channels it is helpful to visualise a person standing with their arms by their sides, the palms facing the legs, rather than in the conventional anatomicalposition. The yang channels then traverse the outer surface of the arm or leg, travel to the head, and with the exception of the Stomach channel, the back. The yin channels traverse the inner surface of the limbs, and the abdomen and chest. More specifically: The channels and collaterals 14 9 the three yin channels of the hand (Lung, Pericardium and Heart) begin on the chest and travel along the inner surface of the arm to the hand. the three yang channels of the hand (Large Intestine, Sanjiao and Small Intestine) begin on the hand and travel along the outer surface of the arm to the head. 8 the three yang channels of the foot (Stomach, Gall Bladder and Bladder) begin on the face, in the region of the eye, and travel down the body and along the outer surface of the leg to the foot. Chest 9 the three yin channels of the foot (Spleen, Liver and Kidney) begin on the foot and travel along the inner surface of the leg to the chest or flank. The course of each of the twelve channels comprises an internal and an external pathway. The external pathway is what is normally shown on an acupuncture chart and is relatively superficial. All the acupuncture points of a channel lie on its external pathway. The internal pathways are the deep course of the channel where it enters the body cavities. The superficial pathways of the twelve channels describe three complete circuits of the body Hand Face A Foot A First circuit Lung Large Intestine Stomach Spleen Second circuit I-leart Small Intestine Bladder Kidney Third circuit Pericardium Sanjiao Gall Bladder Liver NAMING OF THE TWELVE PRIMARY CHANNELS The practice among English-speakingacupuncturists has been to use the same name for each zangfu and its related channel. Thus we talk of the Lung organ and the Lung channel. In practice this may blur the important distinction between the two, and serve to confuse when analysing the different clinical situations of disease of the channel alone, disease of the zangfu alone, or disease of both the zangfu and channel. In Chinese, each has a different name. Thus the Lung zang is known as 'fei' (Lung),whilst Chest its related channel is known as shou taiyin fei jing (the hand taiyin Lung channel). This naming of each channel consists of three parts: i. The zang or fu to which it belongs. ii. The limb (upper or lower) through which it travels. iii. Its yin or yang identity. The twelve channels are paired with each other in two important ways: Limb Yin-yang identity Zangfu Lung hand taiyin (supreme yin) Small Intestine hand taiyang (supreme yang) Spleen foot taiyin (supreme yin) Bladder foot taiyang (supreme yang) Large Intestine hand yangming (yang brightness) Pericardium hand jueyin (absolute yin) Stomach foot yangming (yang brightness) Liver foot jueyin (absolute yin) Heart hand shaoyin (lesser yin) Sanjiao hand shaoyang (lesser yang) Ig Dou Cai, Song, 1146. Case Histories from the Guide to Clinical Patterns (Lin zhPng zhi nAn yi 8n) %$iEgjE@3g Ye Gui, Qing, 1766. Classic of tlze Jade Dragon (Bian Que's Spiritual Guide to Acupztncture and Moxibustion, Jade Dragon Classic) (Yu long jing/BiZn quP shen ying zhen jiti yu long jing) Zhang Zhong Jing, Eastern Han. General Treatise on the Aetiolopj and Syrnptomatolopj of Disease (Zhii bing yuAn hbu lun) 3:&?B!@i,$j Chao Yuan Fang, Sui, 610. Guide to the Classic of Acuptttzcture (Zhen jing zhi nAn) $i-?Wa+i Dou Han Qing, Jin-Yuan, 1241. Helpful Questions in Medical Cases (WPn zhai yi i n ) pdgsg Anon. Illustrated Classic of Acupuncture Points on the Bronze Man (T6ng r6n zhen jiti shii xu6 tti jing) $B,l&&fiflH$$ Wang Wei Yi, Song, 1026. Bibliography Zlltrstrated Strpplenzent to tlze Classic of Categories (Lei jing ~YIyi) p-4- -x $& &# Zhang Jie Bin, Ming, 1624. Introductiorz to Medicine (Yi xu6 ru men) L q gq -7- A r1 fj Li Yan, Ming, 1575. hzvestigatiolz into Points along the Clzannels (Xun jing k5o xu6 bian) @j $$$%)?$8 probably by Yan Z11en Shi, Ming, c. 1575. Lazvs for Plzysicians (Yi men f5 lh) $?&yj&'@ Yu Cl~ang,Qing, 1658. Medical Revelations (Yi xu6 xi11 wil) LgJ ,EE L, ,pg Cheng Guo Peng, Qing, 1732. Meeting the Sotrrce of Acupzrnctzire and Moxibzistion (Zhen jiii f6ng yu5n) $j-&@ jj,?? Li Xue Chuan, Qing. Metlzod of Moxibtrstion at Gaolztrangslzzr (Gao huang shu jii~f5) Q g fi& j& Zhuang Zhuo, Song, 1128. Methods of Actipzirzctirreand Moxibtrstion from tlze Golden Mirror of Medicine (Yi zong jin jihn ci jifi xin f5) r$&2g$J$jj~&lL,& Wu Qian, Qing, 1742. Ode of One Hundred Synzptonzs (B5i zhPng f13) :E I!$\ Gao Wu, Ming, 1529. Ode of Spiritual Briglztness (Ling guang fh) a,:> , , y , 7t; ~ First recorded in Tlze Conzplete Collection of Acziptrncttrre and Moxibtrstion, Xu Feng, Ming, c. 1439. Ode of tlze Essentials of Urzde~stnrzdirzg (Tong xu5n zhi y8o fu) nz\ &~#?jggZ( Firsf recorded in Tlze Great Conzpendiz~i~z of Ac~rpzr~zct~rre and Moxibtrstion, Yang Ji Zhou, Ming, 1601. Ode of the Golden Needle (Jin zhen fu) &$1-1% First recorded in The Complete Collection of Acupt~ncttire and Moxibtrstion, Xu Feng, Ming, c. 1439. Ode of the Jade Dragon (Yu 16ng f i ~ ) zgg$jf, First recorded in Tlze Glorious Anthology of Actipt~nctzrre and Moxibustion, Gao Wu, Ming, 1529. Ode of tlze Obstructed River ( L h jiang fu) #i ?I 118 First recorded in Tlze Glorious Anthology of Actrptrnctzrre and Moxibustion, Gao Wu, Ming, 1529. Ode of Xi Hung (Xi hong fu) 17% $L\pj$ First recorded in The Co~npleteCollection of Actrpu~zcttrrealzd Moxibustion, Xu Feng, Ming, c. 1439. Ode to Elzrcidate Mysteries (Biao you fu) I@\ @ First recorded in Tlze Guide to Acupuncture and Moxibustion, Song, 241. Outline of Medicine (Yi xu6 gang mu) 6%,La-Uq y -F,,&l€! E, Lou Ying, Ming, 1565. Preciozrs Miwor of Oriental Medicine (Dong yi b5o ji8n) g !$$ g$15 Xu Sun (Korean), 1611. Principles of Divine Moxibtrstiolz (Sh6n jifi jing lun) $]I &$g;@ Wu Yang Cheng, Qing. Sagelilce Prescriptions fionz the Taiping Era (Thi ping shPng hui fang) *qq!i'g:~ Wang Huai Yin, Song, 987. Secrets of a Frontier Official (W8i t5i mi yho) gj. g @, 9 Wang Tao, Tang, 752. Secrets of tlze Master of Cinnabar Creek (Dan xi xin fa).jI. g,L, Zhu Zhen Xiang, Yuan, 1347. Song More Precious Tlzan Jade ( S h h g yil ge) \&3 First recorded in Tlze Great Colnpenditim of Aczrptincttrre and Moxibustion, Yang Ji Zhou, Ming, 1601. Song of Ma Dm Ynrzg's Tzoelve Heavenly Star Points (M5 dan y5ng tian xing shi &rxu6 ge) ,g-jI-EzpJ-I-)7gR First recorded in Bian Qtre's Spiritual Guide to Acupuncttrre and Moxibtrstion, Jade Dragon Classic, Wang Guo Rui, Yuan, 1329. Song of Points for Miscella~zeozrsDiseases (Z5 bing xu6 f5 ge) gj+&R&gR First recorded in Tlze Glorious Anthologj of Actrptrnctureand Moxibustion, Gao Wu, Ming, 1529. Song of the Jade Dragon (Yu 1611g ge) 3ggy~ First recorded in Bian Qtre's Spirittral Guide to Actrptrncttrlz and Moxibustion, Jade Dragon Classic, Wang Guo Rui, Yuan, 1329. Bibliography 624 Song of the Nine Needles for Rettrrning the Yang (Htii yang jiti zhen xu6) The Great Compe~zdit~m of Acuptr~zcttrreand Moxibtlstion (Zhen jii3 dB ch6ng) ElE M - R $j-&AE First recorded in The Gloriotrs Anthologcj of Actrpuncttrre and Moxibtrstion, Gao Wu, Ming, 1529. Song of the Primary Points of the Fotirteen Channels (Shi si jing yho xu6 zhti zhi ge). Yang Ji Zhou, Ming, 1601. The Secrets of tlze Heavenly Star (Tian xing mi ju6) * @ % ,& +mmg5Rz?G$'F TIZectlsterngtic c!?lssic t ; F P , c ~ p ~ ? ! c fgf ti : j , A , / l ~ ) ; & ; ~ s ~ j ~ Song to Keep U p Yotrr Sleeve (Zh6u hbu ge) (Zhen jiS jiii yi jing) $+& 93 z+g Jj'f@% Huang Fu Mi, Jin, 282. Thousand Dtrcat Fonntrlas (QiZn jin yBo fang) First recorded in The Gloriotrs Anthology of Acupuncture and Moxibtrstion, Gao Wu, Ming, 1529. Spiritual Pivot (Ling shu) %& See the Yellozo Emperor? Inner Classic. Sta~zdardsof Patterns and Treatments (ZhPng zhi zhtin sh6ng) ?&y, --I a i$AQ Wang Ken Tang, Ming, 1602. Supplement to the Thotisand Dtrcat Formulas (Qian jin yi fang) ?&$!!p? Sun Si Miao, Tang, c. 682. S y s t e m tic Differen tin tion of Warm Diseases (Wen bing ti60 bihn) fg&#g# Wu Ju Tong, 1798. The Classic of Categories (L6i jing) $$ $ 4 Zhang Jie Bin, Ming, 1624. The Classic of Dificulties (Nan jing) gpg Anon., Han. Tlze Classic of Strpplementing Life zvith Actiptrncture rind Moxibtrstion (Zhen jiti zi sheng jing) $+&gpJ=$g Wang Zhi Zhong, Song, 1220. Tlze Classic of the Pulse (MBi jing) Wang S11u He, Jin, c. 300. The Complete Collection of Actrpuncttrre and Moxibtrstion (Zhen jiti dB quiin) $+&A+ Xu Feng, Ming, c. 1439. The Complete Worlcs of ling Ytie (Jing yuP quan shu).q+El3 J53 , 7 /Y. I I 1 3 Zhang Jie Bing (Jing Yue), Ming, 1624. The Glorious Anthology of Actipuncttrre and Moxibtrstion (Zhen jiti ju ying) $i*R% Gao Wu, Ming, 1529. ?&ZZ Sun Si Miao, Tang, 625. Treatise on Disorders of Blood (Xu6 z h h g lfm) &*E n nlm Tang Rong Chuan, Qing, 1884. Treatise on Epidemic Warm Febrile Disease (Wen yi lun) fg@$6 Wu You Ke, 1642. Treatise on Injtrry by Cold (Shang hAn lun) PJ < nlifl Zhang Zhong Jing, Eastern Han. Treatise on the Spleen and Stomach (Pi wPi l h ) p$ 26 Li Ao, Song, 1249. True Lineage of Medicine (Yi xu6 z h h g chuan) m jEi.3 K% 7 3 -7- Yu Tuan, Ming, 1515. Warp and Woof of Wnrm Febrile Disease (Wen rP jing wPi) $g%@I,@ Wang Meng Ying, Qing, 1852. Yellozo Emperor's Inner Classic (Huang dl nei jing) %*rn$$ (Consisting of the Spirittin1 Pivot and the Essential Qtrestions). 'RANSLATORS' TEXTS A Complete Contemporary Hmzdboolc on the Practical Use of Chinese Herbs in Extenzal Medicine (Dang dhi zhong yho wBi zhi lin chuang dB quan) 'gfk+339+fkI23%%3? Jia Yi Jiang et al., China Traditional Chinese Medical Press, 1991. A Concise Dictionary of Classical Chinese (Jiiin ming gti hBn yu ci disn) f$j ~jj&$'$$k$~@ Shi Dong, Yunnan People's Press, 1985. Bibliography - Acupuncture and Moxibustion (Zhen jiii xu6) Histo y of Chinese Acupuncture mzd Moxibustion (Zhong gu6 zhen jiii shi) $+&$ +pJ$-t&p He Shu Huai, Traditional Chinese Medical Classics Press, 1986. Acupuncttrre and Moxibustion (Zhen jiii xu6) Dun Shi Yu, Tianjin Science and Technology Press, 1989. Point Combinations of Clzinese Acupuncture and Moxibustion (Zhong gu6 zhen jifi chi3 fGng xu6) $j- & 9 Lp ~$j-&~&?j&$3 Nanjing College of Traditional Chinese Medicine People's Medical Press, 1985. Acupuncture Points (Zhen jiii yu xu6 xu6) Xiao Shao Qing, Ningxia People's Press, 1986. Practice of External Traditional Clzinese Medicine (Shi ybng zhong yi w8i ke xu6) $i-&k3R% Gu Bai Hua, et al.,Shanghai Science and Technology Press, 1985. Practice of Internal Traditional Chinese Medicine (Shi ybng zhong yi nPi ke xu6) Yang Jia San, et al., Shanghai Science and Technology Press, 1989. Collected Explanations on Points (Jing xu6 shi yi hui jiP) $@@$X@@ Zhang Cheng Xing, Shanghai Translation Publishing Company, 1984. Commentay on the Systematic Classic of Acupuncture and Moxibustion (Zhen jiii jia yi jing jiBo shi) $t&q z:g@$$ Shandong College of Traditional Chinese Medicine People's Medical Press, 1979. Common Terms of Traditional Chinese Medicine in English (Han ying ch6ng ybng zhong yi yBo ci hui) :-I-!-+ IU, [$!!8 H+43$j$i4-@ jzig $yg#$i.$ gmcp-sm'$qg Huang Wen Dong, et al., Shanghai Science and Technology Press, 1985. Practical Foundations of Traditional Chinese Medicine (Shi ybng zhong yi ji chfi xfie) -g-Hcpygg@g Li De Xin, Liaoning Science and Technology Press, 1985. Questions and Anszoers in Traditional Clzinese Medicine (Zhong yi xu6 wPn dB shang he xi&cP) +$g$?pEjgk$uF# Yang Yi Ye, People's Medical Press, 1985. Quintessential Compilatio?z on Chinese Acupuncture and Moxibustion (Zhong gu6 zhen jiii hui cui) +H$t&g%$ Xie Zhu Fan, et al., Beijing Medical College, 1980. Concise Dictiona y of Traditional Chinese Medicine (JiZn ming zhdng yi ci d i b ) fl;$jy+%@E College of Traditional Chinese Medical Research, et al., Joint Publishing Co. Hong Kong, 1979. Dictionary of Acupunctu~eand Moxibustion (Zhen jifi xu6 ci diZn) Zhu Ren Kang, People's Medical Press, 1979. Terminolopj of Traditional Chinese Medicine (Ch6ng ybng zhong yi ming ci shu yu) $t&R%%% #H +gy$EJfjliy~ Wang Xue Tai, et al., Shanghai Science and Technology Press, 1987. Differentiation and Diagnosis of Symptoms in Traditional Chinese Medicine (Zhong yi z h h g zhuBng jiBn bi6 z h h duBn xu6) Sung J. Liao, et al., Hunan Science and Technology Press, 1983. The Great Coinpendit~nzof Act~punctureand Moxibustion Elticidated (Zhen jifi dB ch6ng jiBo shi) cp-~gj~$g~qgl~$ Zhao Jin Duo, et al., People's Medical Press, 1985. Essential Compilations from the Treatise on the Spleen and Stomach (Pi wei lun zfian yab) @ j g $$gg Wang Xue Tai, et al., Hunan Science and Technology Press, 1988. Slcin Disease in Traditional Chinese Medicine. (Zhong yi pi f i i bing xu6) cpgFfifi?@g $t&*E@f$ Heilongjiang College of Research on Native Medicinal Plants et al., People's Medical Press, 1984. The Yellozo Emperor's Inner Classic, Spiritual Pivot, Corrected and Annotated Version (Hu6ng di nei jing ling shu jiab zhu yii di) gs r5$$$7&@@&~$+j~ Shanxi College of Traditional Chinese Medicine, Shanxi Science and Technology Press, 1983. Encyclopaedia of Traditional Chinese Medicine (Zhong yi dB ci diZn) Dun Ai Chun, Tianjin Science and Technology Press, 1989. Treatment zoith Traditional Clzinese Moxibtrstion (Zhong gu6 jiii li6o xu6) +%A%E Zhang Feng Run, et al., People's Medical Press, 1989. WzrS Annotations to the Essential Questions of the Inner Classic (Nei jing st^ wPn wu zhu) Li Yong Chun, et al., People's Medical Press, 1986. Great Fundamentals of the Yellow Emperor's h e r Classic (HuAng di nPi jing tBi su) $@gpp@i% Yang Shang Shan, People's Medical Press, 1965. +H&f?&$? ~$@%~/p&.& Wu Kun, Ming Dynasty, Shandong Science and Technology Press, 1984. 626 Bibliography ENGLISH TEXTS A Colotrr Atlas of Strrface Anatomy Backhouse, Kenneth and Hutchings, Ralph Wolfe Medical Publications Ltd, 1991. Acuptrncttrre, A Comprehensive Text O'Connor, John and Bensky, Dan (trans.) Shanghai College of Traditional Medicine, Eastland Press, 1981. Actrpuncture Cases from China, A Digest of Difficult and Complicated Case Histories Dengbu, Zhang Churchill Livingstone, 1994. Acupt~ncttrrein the Treatineltt of Children Scott, Julian Eastland Press, 1991. A n Outline of Chinese Actrpuncture Academy of Traditional Chinese Medicine Foreign Languages Press, Beijing, 1975. Anatomical Atlas of Acuptrncture Points Co-Operative Group of Shandong Medical College and Shandong College of Traditional Chinese Medicine Shandong Science and Technology Press, Jinan, China 1982. Anatomy of the Htrrnan Body Lockhart, L.D, Hamilton, G.F, Fyfe, F.W. Faber and Faber Limited, 1959. Anatomy, Regional and Applied Last, R.J. Churchill Livingstone, 1978. Celestial Lancets A History and Rationale of Acupuncture and Moxa Gwei-Djen, Lu and Needham, Joseph Cambridge University Press, 1980. Chinese Acupuncture and Moxibustion Mao-liang, Qiu Churchill Livingstone, 1993. Chinese Actrptrncttrre and Moxibustion Xinnong, Cheng (ed.) Foreign Languages Press, Beijing, 1987. Chtrrchill's Illtrstrated Medical Dictionary Churchill Livingstone, 1989. Essentials of Chinese Acupuncture Beijing College of Traditional Chinese Medicine et. a1 Foreign Languages Press, Beijing, 1980. Extra Treatises Based on Investigation and Enqtriry A Translation of Zhu Dan-xi's Ge Zhi Yu Lun Shou-zhong,Yang and Wu-jin, Duan Blue Poppy Press, 1994. Fltrid Plzysiology and Patholopj in Traditional Chinese Medicine Clavey, Steven Churchill Livingstone, 1995. Ftrndementals of Chinese Acuptrncture Ellis, Andrew; Wiseman, Nigel; Boss, Ken Paradigm Publications, 1988. Glossary of Chinese Medical Terms & Acupuncture Points Wiseman, Nigel; Boss, Ken Paradigm Publications. Grant's Atlas of Anatomy Boileau Grant, J.C. The Williams & Wilkins Co., 1972. Grasping the Wind An exploration.into the meaning of Chinese acupuncture point names Ellis, Andrew., Wiseman, Nigel., Boss, Ken Paradigm Publications, 1989. Health Preservation and Rehabilitation Enqin, Zhang (ed.) Publishing House of Shanghai College of Traditional Chinese Medicine, 1988. lllustrated Dictionary of Chinese Acuptrncture Zhang Rui-fu and Wu Xiu-fen (compiled) Sheep's Publications (HK) Ltd. & People's Medical Publishing House, China. Li Dong-ytran's Treatise on the Spleen and Stomach A Translation of the Pi Wei Lun Shou-zhong, Yang and Jian-yong, Li Blue Poppy Press, 1993. Master Hun's Classic of the Central Viscera A Translation of Hua Tuo's Zhong Zang Jing Shou-zhong, Yang Blue Poppy Press, 1993. Surface Anatomy The Anatomical Basis of Clinical Examination Lumley, John S. Churchill Livingstone, 1990. The English-Chinese Encyclopaedia of Practical Traditional Chinese Medicine Xiangcai, Xu (ed.) Medical Qigong, Higher Education Press, Beijing, 1989. The Foundations of Chinese Medicine A Comprehensive Text for Acupuncturists and Herbalists Maciocia, Giovanni Churchill Livingstone, 1989. Tke Heart and Essence of Dan-xi's Methods of Treatment A Translation of Zhu Dan-xi's Dan Xi Zhi Fa Xin Yao Shou-zhong, Yang Blue Poppy Press, 1993. The Location of Acupoints State Standard of the People's Republic of China State Administration of Traditional Chinese Medicine Foreign Languages Press, Beijing, 1990. The Practice of Chinese Medicine The Treatment of Diseases with Acupuncture and Chinese Herbs Maciocia, Giovanni Churchill Livingstone, 1994. Glossary GLOSSARY OF TERMINOLOGY This glossary is designed for two purposes: i. to explain some of the more difficult terminology used in this text, and ii. to refer readers to the original Chinese terms. Abdominal masses (see Masses). Abdominal urgency (li ji @%;) Abdominal cramping and pain, and urgency in the need to defecate, that is most commonly seen in dysenteric disorder. The term is usually used in combination in the phrase 'abdominal urgency and tenesmus' (li ji hbu zhbng @%J;~&EE). Agitation and restlessness (f6n z i o $BE) When used together the terms agitation and restlessness denote an uneasy, restive and anxious state of mind. Agitation is usually accompanied by a warm or hot oppressive sensation in the chest, whilst restlessness suggests a fidgety and restless movement of the limbs. The implication is that agitation is usually generated by internal heat, whilst restlessness comes about from external invasion of heat. Agitation of the Heart (xin f6n lL\il;B) An uneasy and anxious state of mind that is commonly accompanied by a warm or hot oppressive sensation in the chest. Atrophy disorder (wPi zhi.ng :BE) A disorder characterised primarily by flaccidity and weakness of the limbs. In more severe cases and with the passage of time there is increasing loss of control over the movement of the limbs, progressive loss of muscle tone, wasting and atrophy. Biting of the tongue (ni&sh6 @g,ngg, @g). Brain wind (n5o feng 8#E) A form of head wind which is characterised by aversion to cold in the neck and back and a cold sensation of the head and brain, accompanied by severe pain that is hard to endure. Chain and lock point association method (liin stio pi.i xu6 f5 $$@ Em?&). Chest painful obstruction (xiong bi $@$) Stuffiness, oppression and pain of the chest (and breast), usually due to i. weakness of circulation of yang qi in the chest, ii. obstruction by phlegm, or iii. blood stasis. Childhood accumulation disorder (xi50 6r ji shi /J\R@&). Childhood fright epilepsy (xi50 Q jing xi6n /J\,RlB@) This term has two meanings : i. one form of epilepsy seen in children that is triggered by sudden fright; ii. acute childhood fright wind. Childhood fright wind (xi50 er jing feng /J\,El@R) A disorder of infants and children characterisedby convulsive spasm of the limbs and loss of consciousness. It is generally subdivided into acute and chronic fright wind. Acute childhood fright wind is far more commonly encountered and often develops during the course of an acute illness such as dysentery or meningitis. There is usually rapid onset of a very high temperature, great restlessness, redness of the face and lips, coarse breathing, lockjaw, stiffness and pain of the neck and back progressing to convulsive spasms, opisthotonos and finally loss of consciousness. Chronic childhood fright wind is a term reserved for disorders characterised by slow and weak periodic attacks of convulsive spasms. It is often accompanied by a slightly elevated temperature, sallow complexion and general lethargy. Childhood nutritional impairment (xi50 6r gan ji /J\REf@i) Malnutrition due to a variety of disorders. Manifestations include sallow complexion, emaciation, poor digestion, withered hair, enlarged abdomen with pronounced veins, exhaustion and spiritless demeanour. Childhood umbilical wind (xi50 6r qi feng /J\,Rn7?D4; qi feng @El; feng chh qi ri feng -k El D4; qi ri k6u jin k El 1%) Convulsions, opisthotonos, and lockjaw following infection of the umbilicus in the new born. mfs; Clonic spasm (chi zbng, chi. zbng, @:@) A disorder characterised by brief muscular contractions followed immediately by muscular relaxation. It is seen in a range of conditions including: i. febrile disease due to injury by exterior pathogens, where severe heat injures the yin, leading to stirring up of wind and fire and accumulation of phlegm-fire; ii. epilepsy and tetanus characterised by wind-phlegm and phlegm-fire; iii. summer heat which injures the qi and body fluids. Clove sore (ding chuang :fig) A small hard deep-rooted clove-shaped purulent lesion. Clove sore is primarily due to unregulated diet or external wind and fire poison which invade the superficial portion of the body. The condition tends to develop very rapidly with severe localised pain, redness and swelling, often accompanied by fever. Cold inversion ( h h ju6 %H) This is one form of inversion pattern (seehzversion co~interflozu below) that cokes about as a result of deficiency of yang and excess of yin. Cold or damp (dong) diarrhoea (dbng xi6 $iJ~il!!9 There are two meanings to this term: i. cold diarrhoea which occurs soon after eating, with undigested food in the stools; ii. diarrhoea due to invasion of the Spleen by dampness which leads to frequent watery diarrhoea or frequent passing of loose stools, accompanied by a thick greasy tongue coating and a soggy (rti $%) pulse etc. Corporeal soul (pb @) Correct qi (zhi.ng qi X%)i. the totality of a person's qi that is derived from pre- and post- heaven qi (also known as true qi, zhen qi g%); ii. contrasted to pathogenic qi, it denotes the body's general resistance to disease. Counterflow qi (ni qi @%) Qi that flows counter to its normal direction. This term is sometimes used to mean the same as rebellious qi (shang qik$Z,) of the Lung or Stomach, or else as a general term denoting abnormal movement of qi, for example in the limbs where it manifests as coldness due to warming qi not reaching the extremities (see Inversion cou~zterflozu). Glossary Crane's knee wind (he xi feng fi!%R$EL) Also known by a variety of names including 'wandering knee wind', 'crane's joint' and 'eyes of the knee wind'. The disorder is characterised by swelling and enlargement of one or both knees with subsequent atrophy of the area above and below the knee, hence the resemblance to the legs of a crane. usually pronounced. The primary aetiological factors include prolonged emotional strain that leads to stagnation, irregular diet, excessive consumption of alcohol, and chronic parasitic disease. The subsequent damage to the Spleen and Liver caused by the above factors will give rise to stagnation of qi, stasis of blood, accumulation of damp and poor circulation of fluids. Defensive qi (w&iqi @%)A form of yang qi that circulates outside the channels in the superficiai, exterior portion of the body. Its primary functions include defending the body against exterior pathogenic factors, warming the body and controlling the opening and closing of the pores. Dysenteric disorder (li ji !fig;xi8 li 7;B; li B ) This term is used to descrybe a variety of diseases ranging from acute dysentery to chronic disorders such as ulcerative colitis and Crohn's disease. The principal symptoms are diarrhoea several times a day with relatively scanty amounts of stools passed, accompanied by abdominal pain and tenesmus. Pus, mucus or blood may frequently be mixed with the stools. If pus or mucus predominate it is known as white dysentery (b6i li $ @). If blood predominates it is known as red dysentery (chi li This condition is usually differentiated into excess type, and deficiency complicated with excess type. It is primarily due to damp-heat, heat, epidemic poison or stagnant food. Chronic forms are mainly due to Spleen and Kidney yang deficiency and cold, usually complicated with heat. Deficiency taxation (xu 160 E%)A general term used to describe a variety of disorders associated with injury to and depletion of qi, blood and the zangfu. The aetiology includes deficiency of the preor post- heaven qi, prolonged illness, improper diet, excessive sexual activity, improper treatment. Symptoms and signs will vary according to the severity and location of the deficiency. Dementia (dai bFng 86; dai %; chi dai %%; b6i chi B%)A disorder due to phlegm-damp which obscures the portals of the Heart. It is primarily caused by: i. stagnation of Liver qi due to emotional depression that overacts on the Spleen and Stomach, or ii. injury to the Spleen and Stomach from improper diet or lifestyle. The clinical inanifestations are many and varied and include an inability or lack of desire to speak, eat or drink for days on end, neglect of appearance and cleanliness, crying and laughing inappropriately, remaining in the same position for hours on end, indulging in bizarre and obsessional behaviour etc. Diarrhoea containing undigested food (sun xi6 $&,'a:(@; shiii gii li 7JY &$I]) Diarrhoea with undigested food in the stools. Most commonly due to Spleen yang deficiency, but may also be due to exterior invasion of wind, damp, cold or heat. %!a). Erysipelas [cinnabar toxin] (dan dfi R-g-)A skin disorder that broadly corresponds to erysipelas and cellulitis in western medicine. Initially there is a well-circumscribed fresh-red, burning hot lesion that quickly spreads. It is accompanied by chills and fever, headache and thirst. In severe cases fire poison invades the interior leading to high fever, agitation and restlessness, delirium, incoherent speech, nausea and vomiting. This condition primarily affects either the head and face, or the lower limbs. When in the upper region it is mostly due to wind-heat transforming into fire; when in the lower region it is mostly due to damp-heat transforming into fire. Essence (jing 4%) The vital material basis of the human body which maintains the fundamental activities of life. It includes the essence of the Kidney (pre-heaven essence) and the essence of water and grain (post-heaven essence). Diarrhoea due to injury by food (shi xiP &,'a:(!i). Ethereal soul (hfin $5). Diarrhoea with thin stools (t6ng xi6 ?B,'a:(l!i). Fifth-watch diarrhoea (wii geng xi6 ZE,'a:(@). Difficult ingestion (shi bfi xi8 B T T ; yin shi bu xi&%B;I;T;; xia shi F7;@). bfi Difficult urination (xi50 bi8n bfi li /J\@?I;$IJ)Difficulty in passing diminished amounts of urine. Diminished qi (sh5o qi /il$%) Abroad term used to indicate weakness and feebleness of the voice, shortness of breath and general listlessness. Although in theory this condition may arise from weakness of qi of any of the zang, it is primarily associated with deficiency of Lung qi. Disorientation (hu5ng hu 'i%'l%9 A term that is used to describe a distracted state of mind. The patient is flurried, bewildered, alarmed, and unable to manage basic tasks. It mostly originates from longterm emotional strain, exterior pathogens that injure the interior, or excessive sweating which injures Heart qi and disrupts the mind. Drum distention (gii zh8ng BRE; gii Il$J; gii zh8ng I$?dE) A disorder characterised by drum-like swelling and distention of the abdomen with a marked and prominent network of veins clearly visible. If present, oedema of the limbs is usually slight, whilst jaundice is Five accumulations (wfi ji 5 t g ) A group of disorders mostly characterised by the formation of masses (subjectiveor objective) in the chest or abdomen. They are differentiated into five types according to the mode of development, disease mecl~anism,location and nature: Heart accumulation, Liver accumulation, Lung accumulation, Spleen accumulation and Kidney accumulation. Five palms agitated and hot (wii xin fa rP 5&$B$A) A hot sensation felt in the palms of the hands and soles of the feet, usually accompanied by heat and agitation of the chest. This symptom is primarily due to deficiency of yin with blazing of fire although it may also be seen in cases of deficiency of blood or stagnant heat, or as a sequela of febrile disorders. Five taxations (w'ii160 E%)According to the Spiritual Pivot (Chapter 18) the five taxations are: i. excessive use of the eyes which injures the blood; ii. excessive lying down which injures the qi; iii. excessive sitting which injures the flesh; iv. excessive standing which injures the bones, and v. excessive walking which injures the sinews. In later texts, the term five taxations was also used to refer to taxation of the five zang, thus: i. Heart taxation, principally involving damage Glossary to Heart blood; ii. Spleen taxation due to overeating or excessive worry and pensiveness which injure the Spleen qi; iii. Lung taxation involving depletion of Lung qi or yin; iv. Kidney taxation involving damage to Kidney qi from excessive sexual activity; v. Liver taxation involving injury to Liver qi by mental excitement, with such signs as unclear vision, pain of the chest and hypochondrium, flaccid muscles and sinews and difficulty of movement. sudden dyspnoea, a propensity to be easily frightened, dry throat, belching and a deep and thready pulse. Flaccid tongue (she hu5n %$%)The sudden onset of a slack or limp tongue accompanied by rumbling phlegmy-sounding speech and an inability to speak coherently. It is primarily due to windphlegm obstructing the channels. Insufficiency of spirit qi (sh6n qi bu zti @%?,@). a%) Focal distention (pi qi Focal distention is one of the five accumulations, pertaining to the Spleen. It is characterised by a sensation of a localised lump like an upturned cup in the epigastric or chest region, accompanied by a feeling of distention and fullness. It comes about as a consequence of stagnation of the circulation of qi, usually due to deficiency of Spleen qi. As the condition progresses there is wasting of the muscles, lack of strength in the limbs and eventually jaundice. Four command points (si z6ng xu6 !El%%%) A pre-Ming dynasty grouping of points that first appeared in print in The Glorious Anthology of Actiptincttire mzd Moxibustion by the Ming dynasty author Gao Wu. The four command points are: Zusanli ST-36 for disorders of the abdomen; Weizhong BL-40 for disorders of the lumbar region and back; Lieque LU-7 for disorders of the head and nape; Hegu L.1.-4 for disorders of the face and mouth. The six command points were derived from Gao Wu's four command points by later commentators who added Neiguan P-6 for disorders of the chest and lateral costal region, and Renzhong DU-26 to rescue urgent situations. Fright palpitations (jing ji W'l'5) A form of palpitations that may either be triggered by fright, or in which fright may be an accompanying symptom. Gathering qi (z6ng qi Z % )Formed by the combination of the essence of food and drink and the qi of air. By nourishing the Lung and Heart, it has two principle actions: i. to control respiration and the voice, and ii. to circulate the blood. Hot inversion (re ju6 %EE) A form of inversion pattern. There are two kinds: i. inversion pattern due to excessive heat which depletes the yin; ii. inversion pattern due to severe heat which creates stagnation of yang on the interior and thus fails to reach the exterior. Internal eye obstruction (n6i zh&ngIxlR). Interstices (cbu li A%FE). Inversion counterflow (ju6 ni E@)i. inversion frigidity of the four limbs (severe cold either of part of the limb or of the entire limb); ii. severe pain of the chest and abdomen with sudden frigidity of the legs and feet, agitation and inability to eat; iii. one form of chronic headache. Inversion counterflow of the four limbs (si ju6 1 3 PIE@) A broad term that is used to describe coldness of the hands and feet that comes about as a result of disruption in the flow of qi. It may be due to deficiency (for example yang deficiency where the cold sensation tends to extend further up the limbs towards the elbows or knees), or excess (for example heat or qi stagnation, in which case only the tips of the extremities are affected). Inversion qi (ju6 qi E%)Disordered and contrary flow of qi. Leg qi (ji5o qi 88P %) A disorder characterised by numbness, pain and weakness of the legs and feet. Alternatively there may be spasm, swelling, redness and heat of the legs and feet. In severe cases the pathogen attacks more deeply, affecting the abdomen and Heart, in which case there is also discomfort of the abdomen, vomiting, no desire to eat, palpitations, oppression of the chest, dyspnoea, disorientation and deranged speech. Leg qi is primarily due to exterior attack of pathogenic dampness and wind poison, or else due to excessive consumption of rich and greasy foods that generate dampness and heat which will slowly flow downwards to the legs. Loss of speech, inability to speak (yAn yii bu n6ng gZ?$E). Grain qi (gfi qi 8%). @m) Head wind (t6u feng i. severe, long-standing and repetitive headaches (for example migraine) that are recalcitrant to treatment, in contrast to a single incident of headache; such headaches are considered to be mostly due to external invasion of wind-cold or wind-heat that lodge in the head, or to stagnation of phlegm and/ or blood that obstruct the channels; ii. a condition deriving from attack by exterior wind which invades the channels of the head and gives rise to headache, dizziness and deviation of the mouth and eye. Heart painful obstruction (xinbi iL\@) A form of painful obstruction (bi) pattern that affects the zang. It may be due to: i. exterior pathogens that lodge in the body for a long period of time, eventually entering the Heart; or ii. excessive deliberation that injures and depletes Heart qi and blood and predisposes to repeated injury by exterior pathogens that may then easily invade the Heart. The result is obstruction of the Heart qi and channels of the chest. Symptoms include an oppressive sensation of the chest, palpitations, heart pain, Loss of voice (shi yin gg;shi yin bu yii #G?%; w13 yin mg). bing E:@; yin y5 GnG; yin Lotus flower tongue (zhbng she EEZ; zi sh6 7%; zhbng sh6 feng Skj3$;lian hua sh6 37t73)A condition characterised by distention and protrusion of dark-red or purple coloured blood vessels below the tongue. Little growths may form resembling little tongues, hence the alternative name of baby tongue (3%). These may join together to form larger growths resembling lotus flowers. Systemic symptoms may include tidal fever, headache with stiffness of the neck, difficulty in swallowing food, inability to speak and drooling. Over a period of time erosion may develop. This condition is usually attributed to Heart and Spleen damp-heat compounded by attack of exterior wind. Lung atrophy (fei w6i R$:E)A chronic deficiency disorder where the lungs are said to wither and shrivel, in the same way that the limbs are seen to wither in atrophy syndrome. The clinical symptoms and signs include persistent cough and dyspnoea with expectoration Glossary of thick glue-like and frothy sputum, emaciation, listlessness, dryness of the mouth, throat and lips, tidal fever, withered dry skin and body hair, and a rapid and deficient pulse. Most cases are due to deficiency of yin with blazing of fire. excessive anger, or excessive consumption of alcohol or rich, sweet foods that generate phlegm. It is usually differentiated into: i. stagnation of qi and phlegm; ii. knotting of heat with exhaustion of fluids; iii. stasis of blood; iv. consumption of qi and yang. Lung consumption (fei lao I$!@) Achronic disease characterised by progressive emaciation, cough with blood-streaked sputum, low grade tidal fever, night sweats, lethargy etc. It corresponds to pulmonary tuberculosis. Original qi (yuan qi E S ; ZS)Denotes the original yin and original yang of the body. It originates in the Kidneys and is formed from pre-heaven essence, although it is dependent on nourishment from the post-heaven essence derived from the Stomach and Spleen. Original qi is stored in the 'cinnabar field' (Dantian and flows to all parts of the body via the sanjiao, gathering at the yuan-source points and acting as the source of all transformation and movement in the body and as the promoter of the activity of the zangfu. Malign blood ( P xu6 EIfll). Mania-depression (dian kuang @E)A broad term for insanity and mental derangement bridging the spectrum from depressive behaviour (dian) to manic episodes (kuang).Depressive behaviour includes depression, melancholy, dislike of talking or incoherent speech, mumbling to oneself and slow movements. Manic behaviour includes wild frenzied movement and speech, hallucinations, feelings of boundless strength, violent behaviour, insomnia etc. Most cases are due to accumulation of phlegm or phlegm-heat in the Heart that disrupts the spirit. Manic ghost talk (kuang gui yfi !l'3%%). Masses (zheng jig ji jti @@ @%) A collective term for abdominal masses. Masses are considered to develop as a result of emotional stagnation, depression and frustration or internal injury by food. These in turn lead to injury of the Liver and Spleen and eventually to insufficiency of correct qi. The terms zheng and ji (%?@) refer to hard, immovable masses with fixed pain which are generally associated with disorder of the zang and blood. The terms ji5 and ju (!E%) refer to masses of indefinite form which tend to accumulate and dissipate relatively rapidly giving rise to pain of no fixed location. They are generally associated with disorder of the fu and qi. Most commonly in classical texts however, these terms are found in combination, for example zheng jig and ji jti, reflecting the commonly encountered clinical pattern of combined qi stagnation and blood stasis. Zheng jig (BYE)masses mostly occur in the lower jiao and are closely associated with gynaecological disorders, whereas j'i ju ( f g R )masses tend to occur in the middle jiao and are closely associated with digestive disorders. Melancholy crying ghost talk (bei ku g6i yfi ?&%!%%). Nasal congestion and discharge (bi yuan @i?H). Nutritive qi (ying qi ;&Ei,) A form of yin qi that circulates within the vessels of the body. Its primary functions include nourishment of the body and the formation of blood. Obstructed urination (16ng bi #@A; 16ng !@; bi 16ng M!E) Reduced urinary flow, with difficulty in urination. In milder cases (16ng @) there is difficulty in passing urine, that comes out in drops. In severe cases (bi M) there is total retention of urine. Oesophageal constriction (ye g6 ER@; ge B; ye sai @%; ye zhong @$; g6 yan slm)This condition is characterised by a sensation of blockage of the throat on swallowing, and/or a blockage further down at the level of the diaphragm. In advanced cases food that is ingested gets stuck between the throat and diaphragm or else is vomited up soon after ingestion. Oesophageal constriction comes about as a result of emotional constraint leading to stagnation of qi, Painful obstruction (bi $@)A disorder characterised by obstruction of the circulation of qi (primarily due to penetration of wind, cold and damp) that leads to pain. The pain most frequently occurs in the muscles, sinews, joints and bones, although any part of the body may be affected, including the internal organs. In terms of modern medicine it corresponds to rheumatic and arthritic disease. Painful urinary dysfunction (lin zheng $&!Z) A general term referring to urinary difficulty, urgency and frequency. Urination is accompanied by some degree of pain of the urethra and in some cases the hypogastrium. Dribbling of urine often follows urination. Painful urinary dysfunction is usually classified into one of five types depending on presentation:i. qi painful urinary dysfunction; ii. blood painful urinary dysfunction; iii. stone (or sand) painful urinary dysfunction; iv. turbid painful urinary dysfunction, and v. taxation painful urinary dysfunction. Note that hot painful urinary dysfunction is not included in this classification,primarily because in practice it is considered to be present in most types of painful urinary dysfunction. Pathogenic qi (xie qi !$P%i,) i. disease-causing factors that originate outside the body, namely wind, cold, damp, dryness, fire, summer heat and epidemic pestilential qi; ii. a general term for all disease causing factors. A subjective sensation of a lump Plumstone qi (m6i h6 qi ;l@&S) obstructing the throat. Efforts to cough it u p or swallow it are futile. It is frequently exacerbated by emotional upset, and diminished by relaxation a n d emotional ease. It is often accompanied by an oppressive sensation of the chest, frequent sighing, nausea and depression. Plumstone qi corresponds to globus hystericus in modern medicine. Pounding of the heart (zheng chong 'lE1l$)A form of severe palpitations. The and pounding tends to be intense and can often be felt in a broad area ranging from the chest to the umbilicus. It is considered to be a more serious and advanced condition than the other forms of palpitations (palpitationsand fright palpitations), from which it often develops. ;shen sh6 I%!?) The tongue Protrusion of the tongue (she zbng k## is extended out of the mouth and the patient finds it difficult or impossible to retract it. It is often accompanied by a scorching hot sensation of the tongue and mental disturbance. This condition is considered to be primarily due to phlegm-heat agitating the Heart. Purple-white wind blotches [pityriasis versicolorl (zibai dign feng 22 QYFZrn). Glossary 631 Restless zang disorder (zang zao )@%$Jl An episodic mental disorder most commonly occurring in women, characterised by a variety of symptoms such as agitation, restlessness, oppression of the chest, disturbed sleep, irritability, rash and impetuous bel~aviour,abnormal speech, frequent yawning and stretching,disorientation,worry, grief, weeping, sighing, and even convulsions without complete loss of consciousness. It is generally considered to come about as a consequence of emotional frustration which impairs the smooth flow of Liver qi, or worry which injures Heart yin and blood. Historically this condition was also associated specifically with blood deficiency of the uterus, drawing parallels with the original Western concept of hysteria which is how zang zao is sometimes translated. iv. flesh extreme; v. bone extreme, and vi. essence extreme. Six command points (liu z6ng xu6 * % E f i ) see Four conzmnd points. Slippery diarrhoea (hui xi6 #:1@) Chronic diarrhoea that gives rise to the downward collapse of qi, which in turn will lead to such symptoms as ceaseless diarrhoea (both at night and during the day), diminished appetite, inversion counterflow of the four limbs or oedema of the limbs, generalised sensation of cold, shortness of breath, emaciation and deficiency fever. It is usually differentiated into hot and cold types. Spirit (sh6n @). Rhinitis (bi qiti &#L) Clear nasal discharge, often accompanied by stuffy nose, itching of the nose and sneezing. It is mostly due to Lung qi deficiency resulting in weakened ability of the defensive qi to firm the exterior which in turn will lead to invasion of exterior wind. Sabre lumps (mii dao ,RZ) Scrofulous tumours that appear on the body in the shape of a sabre. Scrofula (liio li @@ A term primarily used to describe nodules on the sides of the neck, but includes also the axilla and inguinal region. Small nodules are known as 1Qo(B), large ones as li (5%).They come about as a consequence of: i. deficiency of Lung and Kidney yin; ii. long-term stagnation of Liver qi; and iii. deficiency fire that condenses the body fluids to form phlegm. In the early stages of the disorder, small bean-sized nodules that are neither hot nor painful emerge. As the disorder develops the nodules often enlarge, form into a linear pattern and become firm and immovable. If the nodules burst, a thin clear liquid is usually discharged. Occasionally a thicker (bean-dreg like) liquid is discharged. In chronic cases an open sinus forms with continual exudation. Steaming bone disorder (gii zheng B Z )A feverish sensation that feels to the patient as if it emanates from deep inside the bones and marrow. It is mostly due to deficiency of yin with blazing fire, and is commonly accompanied by tidal fever, night sweats, agitation and restlessness, insomnia, heat sensation of the palms, dyspnoea and dark urine. Stiffness of the tongue (sh6 qiing sfrS2)Stiffness of the tongue and loss of ability to control fine movements of the tongue. It is often accompanied by difficulty in speaking, or by total inability to form coherent words, and is most frequently encountered as a sequela of wind-stroke. Stone oedema (shi shiii 67&) One form of oedema that is mostly due to yin cold of the Liver and Kidneys, with stagnation and accumulation of fluids in the lower jiao. Symptoms include swelling of the hypogastrium that feels hard like a stone, distention and pain below the lateral costal regions, fullness of the abdomen and a deep pulse. Sudden fright disorder in children (xiiio 6r k6 wii /1\5!,%'1?) A disorder of children that is due to weakness or immaturity of the spirit qi. On being startled (for example by seeing a stranger, or suddenly hearing an unexpected or unfamiliar noise) the child suddenly becomes very frightened and begins to weep. Windphlegm, generated by the shock, will subsequently disrupt the Spleen and Stomach giving rise to vomiting, diarrhoea and abdominal pain, and ultimately to clonic spasm. Seven injuries (qi shang -k@) 1.The seven disease causing factors: i. injury to the Spleen from excessive eating; ii. injury to the Liver from excessive anger; iii. injury to the Kidneys from excessive labour and lifting, as well as extended periods of time spent sitting on damp ground; iv. injury to the Lung from cold or retention of cold fluid; v. injury to the Heart from prolonged anxiety and worry as well as excessive deliberation; vi. injury to the body from wind, rain, cold and summer heat and vii. injury to the emotions from great fear and dread. 2. A collective term for the seven manifestations of depleted Kidneys in men: i. cold genitals; ii. impotence; iii. abdominal urgency; iv. seminal emission; v. insufficiency of essence (semen) with dampness of the genitals, vi. thin semen; vii. frequency of urination, dribbling of urine or interrupted urination. Sudden turmoil disorder (hub luan Zgl) A disorder characterised by sudden onset of simultaneous and severe diarrhoea and vomiting, accompanied by abdominal discomfort and pain. It is most commonly associated with unclean food, injury by cold, summer heat and dampness, or epidemic qi. Sexual taxation (fing lio E%;nil 150 &%; fing shi shang BZZlg) Exhaustion due to depletion of the Kidneys by excessive sexual activity. Superficialvisual obstruction (mu yi $3;yi zhang 53% ;mu zhong A thin membranous growth on the eyeball that yi zhang H impedes vision. a) Shan disorder (shan There are three general definitions for this term: i. the protrusion of an organ or tissue through an abdominal opening; ii. severe pain of the abdomen accompanied by constipation and retention of urine or difficult urination, and iii. a general term denoting disease of the external genitalia, testicles and scrotum. Taxation fever (150r6 %%\)A form of fever associated with deficiency taxation patterns, frequently accompanied by steaming bone disorder, agitation and heat of the five palms, dryness of the mouth etc. It is primarily due to yin deficiency with blazing fire, although other possibilities include deficiency of yang, blood or qi. Six extremes (liu ji *$I$) A collective term for six types of extreme deficiency disorders. According to the Thousand Ducat Formulas the six extremes are: i. qi extreme; ii. vessel extreme; iii. sinew extreme; Tetany (jing @) A disorder characterised by stiffness and rigidity of the neck and back, lockjaw, twitching of the limbs, opisthotonos etc. It can usefully be differentiated into excess and deficiency types. Glossary 632 The excess type mostly results from wind, damp, cold, phlegm, and fire pathogens stagnating and obstructing the channels and collaterals. The deficiency type mostly results from excessive sweating, loss of blood, deficiency of qi and blood or depletion of fluids giving rise to malnourishment of the sinews and the generation of internal deficiency wind. The eight therapeutic methods (ba f5 A&) The therapeutic use of the confluent points of the eight extraordinary channels. Thought (yi El. Three corpse possession disorder (san shi z6u zhu 3P%@). Throat Moth (rii P ?L@; h6u P n[%&) This is one-sided or bilateral redness, swelling and pain of the tonsils, which is usually accompanied by foul breath, constipation, chills and fever and a thick greasy tongue coating. Yellow-white coloured pus is clearly discernible on the surface of the tonsils. Throat moth is primarily due to: i. stagnant heat in the Stomach and Lung; ii. fire poison; iii. qi and blood stagnation; iv. old phlegm and Liver fire knotting up and forming blood stasis (malign blood); v. depletion of Liver and Kidney yin with blazing fire. Throat painful obstruction (h6u bi I[%:@, ll[%M)A general term for swelling, congestion and pain of the throat. The term implies that the disorder is relatively mild and will not develop into a critical condition. Accompanying symptoms can include a mild sensation of blockage, hoarseness of the voice, chills and fever etc. Throat painful obstruction can come about as a result of injury by exterior pathogens (mostly wind-heat) or from interior disharmony (mostly deficiency of yin). Thunder head wind (lei t6u feng el) A type of headache that is primarily due to exterior attack of wind, or internal phlegm-fire that generates wind. The headache tends to be severe with a thundering sound in the head. It may be accompanied by swelling and heat of the face and head. Tian gui (tian g i ~ %%) i i. the essential substance responsible for promoting growth, development and reproductive function as well as the maintenance of the menstrual cycle and pregnancy; it is formed from the combined essence of the parents and slowly develops with constant supplementation from the post-heaven qi; ii. in the Classic of Categories tian giii is used as an alternative term for original qi; iii. occasionally used as an alternative name for menstruation. Tidal fever (chfio rP @A%!) A feverish sensation (subjective or objective) that occurs at regular intervals, often in the afternoon and evening. Although deficiency cases are most frequently seen in practice, it may also come about as a consequence of excess patterns. Tongue thrusting (nbng she %k; tu sh6 U!S;shu she $78)This is a disorder where the tongue is repeatedly thrust out of the mouth, then immediately drawn back in and moved up and down, left and right, like a snake's tongue. It is most commonly seen in the pattern of Spleen and Heart accumulated heat, though it is also differentiated into Spleen and Kidney deficiency heat. It is frequently seen during the course of a febrile disease or during an epileptic attack, and is often accompanied by a red distended tongue, ulceration of the tongue and thirst with desire for cold fluids. Uterine masses (see Masses). Visual dizziness (mu xuBn R84;) A type of dizziness that initially starts as cloudy vision before developing into dizziness. This is usually contrasted to vertex dizziness (dian xuBn @ which is used to describe dizziness followed by cloudy vision. Wasting and thirsting disorder (xiso k6 ?AE) A disorder characterised by excessive thirst, hunger and urination as well as progressive loss of weight and emaciation. It broadly corresponds to diabetes mellitus. Water binding the chest (shtii ji6 xiong 7k%R$) Accumulation of fluid in the chest and costal region leading to pain below the heart, with fullness and hardness on palpation. Watery diarrhoea (zhu xi6 -8%; shiii xi6 7&:&, 7kj@;xi6 zhu :it!i>ii:; zhu xi&ST)Diarrhoea that is the consistency of water. It is usually differentiated into damp, cold, and hot types. White turbidity (bAi zhu6 QE)i. turbid white urine; ii. white urethral discharge; even though pain on urination and hesitant urinary flow is present, the urine itself is not turbid. Will (zM Z ). Wind dizziness (feng xuBn E@; feng t6u xuBn E@B@) i. one type of dizziness due to under1ying.deficiencythat predisposes to injury by wind, which then penetrates to the brain giving rise to dizziness, cloudy vision and vomiting; in severe cases there may be continual dizziness, pain of the body and even collapse. ii. in the Thousand Ducat Forrnulas the term wind dizziness is used to denote epilepsy. Wind rash (feng zhPn E i@) A skin disorder that mostly occurs in winter and spring in children aged between one and five. It is due to invasion of exterior wind-heat that becomes blocked at the superficial portion of the Lung (skin). The lesions primarily consist of pink or pale-red macular papules. The condition resolves within one to three days. Wind taxation (feng 1Ao E%)A disorder where exterior wind-cold enters and lodges in the channels and collaterals, giving rise to painful obstruction. If untreated or severe, the pathogen will enter more deeply reaching the fu and subsequently the zang. The consequent injury to the qi and blood will eventually lead to taxation. Wind-taxation lumbar pain (feng lAo yao tbng R%@@i?) Lumbar pain due to attack and injury by exterior pathogenic factors which lodge in the back and over time lead to deficiency. Point names index 633 CHINESE POINT NAMES INDEX Italicised names are alternative names Anmi611 N-HN-54 (Peaceful Sleep) 9 Bafeng M-LE-8 (Eight Winds) Am BBich6ngwb M-LE-34 (Hundred Insect Burrow) Biihu6nshii BL-30 (White Ring Shu) $%!$I BBihui DU-20 (Hundred Meetings) 8% BBil6o M-HN-30 (Hundred Taxations) H% B5ildo DU-14 (Hundred Taxations) E% Baohuang BL-53 (Bladder's Vitals) BEE Baomgn ST-28 (Gate of the Uterus) BEPY Baom6n KID-13 (Gate of the Uterus) BE F7 Baxik M-UE-22 (Eight Pathogens) /I$b BPnshkn GB-13 (Root of the Spirit) $$$ Biguan ST-31 (Thigh Gate) fl$E+I BinBo L.1.-14 (Upper Arm) @F$ Bingfeng SI-12 (Grasping the Wind) Z R Bitong M-HN-14 (Penetrating the Nose) @@ BhlAng KID-22 (Walking Corridor) $!?J;-l"i Bhrong ST-19 (Not Contained) ?I;@ Ch6ngqiAng DU-1 (Long Strong) E$$ Chdoti~ndianDU-1 (Heavenward-Looking Summit) $A%B Ch6ngfu BL-36 (Hold and Support) Skk Chknggu%~g BL-6 (Receiving Light) S.% Ch6ngjiiing REN-24 (Container of Fluids) S.52 Ch6ngjin BL-56 (Support the Sinews) Chkngling GB-18 (Support Spirit) 73% Ch6ngmBn ST-20 (Supporting Fullness) S.$$ Ch6ngqi ST-1 (Container of Tears) S.*& Chkngshan BL-57 (Support the Mountain) ?$ill Chiz6 LU-5 (Cubit Marsh) R @ Chongmkn SP-12 (Rushing Gate) :i$BY Chongy Ang ST-42 (Rushing Yang) 'i$E CiliAo BL-32 (Second Crevice) % fj@ DBbao SP-21 (Great Wrapping) A& Dhch6ngshu BL-25 (Large Intestine Shu) AE& DBdii SP-2 (Great Metropolis) k g13 DBdun LIV-1 (Big Mound) A% DAhZ REN-4 (Great Sen) kg DBhP KID-12 (Great Luminance ) DBhkng SP-15 (Great Horizontal) A$% DBimBi GB-26 (Girdling Vessel) %.'RTk Dhju ST-27 (The Great) A E DBling P-7 (Great Mound) A@ Dsnmu GB-23 (Gall Bladder Mu) j,$$B DBnnAngxu6 M-LE-23 (Gall bladder Point) @aii'i DBnshu BL-19 (Gall bladder Shu) jE& DZntiin REN-4 (Cinnabar Field) RBI DBying ST-5 (Great Welcome) Dhzhong KID4 (Great Bell) k$i2 DBzhh BL-11 (Great Shuttle) A@ DBzhui DU-14 (Great Vertebra) A#$ Dicang ST-4 (Earth Granary) j:& Dich6ng KID-2 (Earth Surge) j:&~$$ Dichong KID-1 (Earth Thoroughfare) i&@i Diji SP-8 (Earth Pivot) ith;ti& DingchuBn M-BW-1 (Calm Dyspnoea) Z % Diwiihhi GB-42 (Earth Five Meetings) j:&fL@ Dubi ST-35 (Calf's Nose) @& Duiduiin DU-27 (Extremity of the Mouth) ,%$% Dushu BL-16 (Governor Shu) @& krb6i M-UE-29 (Two Whites) L Erh6li~oSJ-22 (Ear Harmony Crevice) B$UB Erjian L.1.-2 (Second Space) 1@7 Erjiiin M-HN-10 (Tip of the Ear) Z$$ Erm6n SJ-21 (Ear Gate) Z$Pq FkidiDU-9 (Bottom of the Lung) A$& F ~ i h i SJ-6 i (Flying Tiger) BE FPishu BL-13 (Lung Shu) Hifi& FeiyAng BL-58 (Soaring Upwards) R% Fengchi GB-20 (Wind Pool) Fengfii DU-16 (Palace of Wind) R J@ Fengl6ng ST-40 (Abundant Bulge) @@ Fengmkn BL-12 (Wind Gate) RP9 Fengshi GB-31 (Wind Market) mfi Fhiii SP-16 (Abdomen Sorrow) /@S FubAi GB-10 (Floating White) $-7Q Fhfen BL-41 (Attached Branch) Mrf'% Fhji6 SP-14 (Abdomen Knot) E% Fhliii KID-7 (Returning Current) @i@ FiishP SP-13 (Abode of the Fu) @.% Futonggii KID-20 (Abdomen Connecting Valley) @@$$ FuiA ST-32 (Crouching Rabbit) I%% F6f5 L.1.-18 (Support the Prominence) &% Ftixi BL-38 (Floating Cleft) $-7 Zb Fhy6ng BL-59 (Instep Yang) $ff E m>& Ganshu BL-18 (Liver Shu) flT& Gaohuangshii BL-43 (Vital Region Shu) gE& Gkguan BL-46 (Diaphragm Gate) MB Gkshii BL-17 (Diaphragm Shu) Gongsun SP-4 (Grandfather Grandson) fig Guanchong SJ-1 (Rushing Pass) H@ GuSngming GB-37 (Bright Light) jk Y Guanrnh ST-22 (Pass Gate) PY GuanyuAn REN-4 (Gate of Origin) BZ GuanyuAnshu BL-26 (Gate of Origin Shu) EZ& Guicdng REN-1 (Glzost Store) Gui'chudng ST-6 (Ghosts Bed) BR Gufg6ng DU-23 (Glzost Palace).?ZB Guig6ng DU-26 (Ghost Palace) %g GuilAi ST-29 (Return)%@I Gul7i;i SP-1 (Glzost Fortress) B 3 Gul'lu P-8 (Ghost Road) ,%I$$ Gui'shi REN-24 (Ghost Market) %$ Guitgng DU-23 (Glzost Hall) %B Gu2uiL.L-11 (Ghost Leg),%BE Guki6 ST-36 (Glzost Evil)%@ Gulicin LU-11 (Ghost Faith) ,!%IS a@. Point names index Gul'xn P-7 (Ghost Heart) ,%L\ GuizhGn DU-16 (Ghost Pillow) H5iqudn M-HN-37 (Sea Spring) %&% Hdnfii GB-33 (Mansion of Cold) %B HBnyBn GB-4 (Jaw Serenity) 8BjE Heding M-LE-27 (Crane's Summit) He$ L.I.4 (Toining Vallej7) e 4 S Henggii KID-11 (Pubic Bone) @$g Heydng BL-55 (Confluence of Yang) eB Hbuding DU-19 (Behind the Crown) TgB Hbuxi SI-3 (Back Stream) @@& Hudghi REN-20 (Magnificent Canopy) $3 Huangmen BL-51 (Vitals Gate) Er 7 Huangshu KID-16 (Vitals Shu) E& Huangzhiyuzin REN-4 (Origin of Huang) E'ZE HuBnrnen M-BW-6 (Gate of Suffering) ,@, r 7 HudntiBo GB-30 (JumpingCircle) Egk Hudrbum6n ST-24 (Slippery Flesh Gate) ?Y HuAhlojiSji M-BW-35 (Hua Tuo's Paravertebral Points) %{'?&@ HuiyAng BL-35 (Meeting of Yang) @ B Huiyin REN-1 (Meeting of Yin) @E Huizong SJ-7 (Ancestral Meeting) @Z Hunmen BL-47 (Gate of the Ethereal Soul) ZBPy Jidche ST-6 (Jaw Bone) @@/3 Ji5chengjiiingM-HN-18 (Adjacent to Container of Fluids) g7TC53 Jianjing GB-21 (Shoulder Well) E# Jianlido SJ-14 (Shoulder Crevice) @@ Jihnli REN-11 (Strengthen the Interior) @LE! Jianqidn M-UE-48 (Front of the Shoulder) E E Jianshi P-5 (Intermediate Messenger) VB~@! JiGnwBishG SI-14 (Outer Shoulder Shu) E.tf-& Jianyu L.1.-15 (Shoulder Bone) EW Jianzhen SI-9 (True Shoulder) EB Jianzhongshu SI-15 (Middle Shoulder Shu) @ +& Ji5osun SJ-20 (Minute Angle) B % Jiaoxin KID-8 (Exchange Belief) JiPxi ST-41 (Stream Divide) fiB% JimBi LIV-12 (Urgent Pulse) %aTk Jimen SP-11 (Winnowing Gate) B PY Jinggcing DU-4 (Palace of Essence) $EE Jinggcing BL-52 (Palace of Essence) 4EE Jinggii BL-64 (Capital Bone) Z I B Jingmen GB-25 (Capital Gate) Z ?Y Jingming BL-1 (Bright Eyes) tIE% Jingqu LU-8 (Channel Gutter) $$$% Jinjin M-HN-20 (Golden Liquid) &@ Jinrnen BL-63 (Golden Gate) &F7 Jinsuo DU-8 (Sinew Contraction) @j,@ Jiqudn HE-1 (Summit Spring) &% Jiuwei REN-15 (Turtledove Tail) hQE Jizhong DU-6 (Centre of the Spine) @ Jueyinshu BL-14 (Jueyin Shu) Jubyun REN-5 (Infertility) $I39 Jugii L.1.-16 (Great Bone) E@ Julido ST-3 (Great Crevice) EE Julido GB-29 (Stationary Crevice) EE Juqui? REN-14 (Great Gateway) EFfl + Kdngzui LU-6 ( Maximum Opening) 7LE KouheliBo L.1.-19 (Mouth Grain Crevice) R 7f5+@ Kufdng ST-14 (Storehouse) Kunlun BL-60 (Kunlun Mountains) E 6 LdnwPixue M-LE-13 (Appendix Point) MER Ldogong P-8 (Palace of Toil) %E Lihgmen ST-21 (Beam Gate? 2gF7 Lihngqiu ST-34 (Ridge Mound) Lidnqudn REN-23 (Corner Spring) E&$i Lidui ST-45 (Strict Exchange) @# LiPque LU-7 (Broken Sequence) 34% Ligou LIV-5 (Woodworm Canal) &@$ Lingdho HE-4 (Spirit Path) BB Lingtdi DU-10 (Spirit Tower) B 6 Lingxu KID-24 (Spirit Ruin) S4& L6ngh iixue' DU-1 (Dragon and Tiger Point) E@?fl Lbugii SP-7 (Dripping Valley) @$$ Lubquh BL-8 (Declining Connection) ,%@ LubzhPn M-UE-24 (Stiff Neck) Z;I;% Luxi SJ-19 (Skull's Rest),@&I Meichong BL-3 (Eyebrows' Pouring) Mingguan SP-17 (Gate of Life) &I% Mingmen DU-4 (Gate of Life) &QY Mingtgng DU-23 (Hall of Brightness) %2 Muchuang GB-16 (Window of the Eye) H @ N5oht1 DU-17 (Brain's Door) j&P Naohui SJ-13 (Upper Arm Meeting) NBokong GB-19 (Brain Hollow) a82 Naoshii SI-10 (Upper Arm Shu) iff& Neiguan P-6 (Inner Pass) M NPiting ST-44 (Inner Courtyard) h@ Pdngguangshu BL-28 (Bladder Shu) BE& Pianli L.1.-6 (Veering Passage) Pingyi REN-1 (Flat Screen) F!$$ Pishu BL-20 (Spleen Shu) @& Pbhu BL-42 (Door of the Corporeal Soul) @5%F Pucan BL-61 (Servant's Respect) #@ QiBnding DU-21 (In Front