Recently I have gone back to the basics of Chinese medicine and picked apart such fundamental ideas as the nature of Qi and the process of change. This time I am going to continue that theme with an essay on the meridians and examine exactly what are they if they are not conduits of magic energy which need unblocking occasionally. Instead I want to consider them from the perspective of abstract archetypes from which any level of reality can be described. Their typical Zangfu organ attributions are simply the logical manifestation of that principle on our internal physical landscape, just as their channel pathway is the same principle in the context of physiology and movement. They can equally be applied to social, psychological, environmental or any other level of interaction. Zhang Zhi-Cong (1616-1674) sets a precedent for this way of thinking when he wrote: “Since channels are substantial while qi is non substantial, six qi can encompass six channels, whereas six channels cannot cover six qi” (cited in Liu, 2015, p.135) suggesting that the channels, and presumably the Zangfu as well, are substantial manifestations of an abstract principle.
The principle of Li 理, is also useful for this discussion, literally meaning ‘the grain on wood’ but also ‘pattern’ or ‘universal principle’ that operates in the natural universe and is thought to be mirrored within our bodies and through our mental processes (Bertschinger, 2015: 35-36). Although coined in the 12th century the idea is present in the Tao Te Ching (e.g. Ch. 47: “Without going out your door you can know the whole world” trans. Pine, 2009) and the Neijing in the form of Yin and Yang, the Wuxing 5 phases and, as I intend to show, the meridian system itself. This makes treating a meridian an attempt to focus on our relationship to one of these universal principles in order to modify our approach to that area of life and not an attempt to clean out someone’s pipes. This ought to mean that there are more than just needling points implied in any acupuncture protocol and today I want to look at some of those contexts, drawing on ideas from systemic therapy and its ancient equivalents to highlight some strategies for each meridians.
I am reminded here of Charlie Buck’s comment at the Acupuncture Research Symposium debate this year regarding the difference in meaning of “diagnosis” in western and eastern medicine. In the west we expect a singular definition of the problem, an abnormal test result that can be reliably reproduced by any clinician who runs them, correction of which results in a return to normal functioning. In Chinese medicine a diagnosis evaluates a person’s entire life situation, going broad instead of narrow, and is more like a chess player’s appraisal of the board, describing our strategy which will depend on the approach of the player, the pieces they have available and the moves they can make. Multiple paths to the same goal are possible and different players will have different styles but they will always have to move within the rules of the game. The board is our entire life situation, its pieces and the ways they can move its meridians and they all connect in the body on which all spheres of our existence depend (see Schipper, 1993, The Taoist Body for a thorough analysis of the importance of the body in Taoist philosophy).
With no body there is no life, no brain to think, no heart to feel, nothing with which to perceive the environment and nothing to interact with other people and so it is through the body we are able to make changes in our life, for better and for worse. Whereas Buddhism has traditionally emphasized detachment from these to find a pure consciousness, the mind has always been a bodily construction for Taoists and so the body is the central axis around which all areas of life revolve. As all these spheres connect with the body we find that every impact on one level has repercussions on every other, so a physical injury or illness can impact us psychologically and socially, in terms of our occupation or ability to function. Equally social ills will see the rise of certain physical and mental problems in individuals making trends in health a mirror of the political or natural environment. Treatment should aim to address all aspects of the problem: physical, mental, social, even modifying the environment to be more accommodating if we can and accounting for political causes that may be beyond our direct control. This also means that each of these modes of treatment also has the possibility to facilitate change on other levels as they all use the body in some way as the thing which can be acted upon or encouraged to change its actions. In order to do this a set of meridians that reflect the universal pattern in all things is required. Then as the Tao Te Ching Ch. 54 says:
“Just as through one’s own body one may contemplate the body,
So through one’s family one may contemplate the family,
And through one’s country contemplate the country,
And through one’s world contemplate the world.” (trans. Schipper, 1993: 189)
We can then develop a solution to whichever area is causing the most problem by adhering to the same principles but changing the specifics.
Highly abstract concepts like this often need metaphors to be grasped clearly and manipulating metaphors for the body has been a common theme in traditional medical practices the world over. Anthropologists have suggested the mechanisms operating behind much shamanic healing is the manipulation of symbols in a narrative that guided the person to self-adjustment (Levi-Strauss, 1963). This principle is still at work in medicine today, although the symbols are often scientific and medical instead (Moerman, 2002). Ironically in declaring themselves the bastions of truth, scientists have made their language the perfect medium for lies. By adding some Latin names for muscles and quoting a study or two it has become easy for the health industry to play on our beliefs about our bodies by denying them to be beliefs.
By contrast the Chinese Taoists saw reality as something phenomenal and sought to describe these phenomena in any way that conveyed the essence of how they felt. They imagined their internal landscape as anything from a community of people (Su Wen, Ch. 8) to a landscape full of mountains, rivers and settlements (The Book of the Centre in Schipper, 1993: 105-108), to daily or yearly cosmological cycles (Bertschinger, 2015: 94-100 & 233-235, Su Wen, Ch. 9 & Ch. 66-74), or an alchemical experiment (Pregadio, 2011: 65-97). Even when they are not using metaphors deliberately the Chinese script is such that imagery is always present. This makes its descriptions of internal states particularly vivid and while we can argue about what they really meant in modern terms, they still provide a simple guide to reproducing the method, by feeling what they felt and copying the actions to observe a change that fits the pattern described. Since the meridians were the archetypes around which each description was centred, this means manipulating the metaphor in order to change our relationship to the principle it represents, to see that change filter into all the aspects of our life that it covers. It does not matter if we visualise what is actually there, say a tight muscle relaxing, or something more imaginative like a door opening to let a crowd of people out, or a dammed river being released and allowed to flow, or a storm easing and sunshine returning, as long as it works. After all, no one feels their body exactly as it is or we would have no need for modern scanning equipment or anatomical dissection to learn what is really going on. Instead they tried to control their internal environment through developing sensitivity to the way we feel it to be, learning what effects each visualisation has and repeating them until they become reinforced. Any image we use to achieve this is acceptable along with any external aids such as acupuncture or massage to make it more vivid.
It seems that a few steps are being taken to understand this by neuroscientists with Paul Zak (2015) recently publishing an article on how narratives cause the release of oxytocin, a neurostransmitter known to be involved in acupuncture, which makes us more likely to respond to social demands, and David Linden (2015) examining the power of touch and its essential role in our lives. Linden’s book examines how touch, feeling, emotion and meaning are inextricably entwined. Almost unconsciously we use it in phrases like “a rough day” or “a sticky situation” and refer to our emotions as “feelings” which can be “touched” or “hurt”. It may even be wired into our most primitive aspects of the brain, as evidenced by the fact that Koko, a gorilla trained in sign language, when asked what was “hard” was able to reply “rock” and “work” (McGraw & Warner, 2014). Being touched with a needle, with all its medical and invasive connotations must be even more semantically loaded! Even so, I am not aware of any study attempting to combine the two and find out how the meaningful language of touch, used to tell a visceral narrative played out our body, can affect us but it does raise the possibility that they may make us more receptive to a therapeutic goal and maybe even one of internal body control. I expect it would be quite hard to design but that the results would be very interesting. It is certainly an impression I get from many treatments I have performed, especially the more dynamic ones using tui na or ahshi needling. I am palpating to build up a setting in a landscape of mountains and valleys where an invader or a rebellious faction is causing pain to an area, blocking the rivers causing flooding or drought, scorching the land and disrupting trade routes. My role is to challenge the upset, gather intelligence, raise an army of our own, erode support from nearby painful spots to weaken the rebels, chase them out of their fortress and support the survivors in rebuilding their land. Even when I do not have any specific dramatic setting in mind, which is probably most of the time, I do find a sense that as I move from one place to the next I am feeling for patterns, sending messages and looking for responses until we reach a satisfying conclusion, more like a dialogue than a monologue but still with themes, meaningful actions and an evolving story.
This idea of communicating without words is important in Taoist philosophy. Recall the words of Laozi: “sages … teach wordless lessons” (Tao Te Ching Ch.2, trans. Pine, 2009), or Zhuangzi: “Words are for [capturing] meaning: when you’ve got the meaning, you can forget the words. Where can I find someone who’s forgotten words so I can have a word with him?” (trans. Watson, 2013). An important aspect of wordless teaching is the possibility of plurality in interpretation, especially when using archetypal actions as are done in ritual (Humphrey & Laidlaw, 1994). This means that even if the performer and observer have different interpretations from different frames of reference they can still connect and infer a sympathetic meaning because the relationships between the principle archetypes contain the same essential message. I believe this plays a crucial part of any Chinese medical practice too.
Narrative approaches can be used on many other levels than just bodywork and have been employed in western therapies by writers like Michael White (1990) in the sphere of social behaviour. White’s approach uses the metaphor of a script, like imagining that the problem episodes are episodes in a TV drama and if you were the script writer, how would you change your character’s actions to affect a different outcome? This is a useful system to employ in helping people find out their sphere of influence over a problem but it would take the addition of some meridian-like archetypal characters (gods?) and themes to be playable on every level. Another method of White’s that comes even closer to a shamanic rite is called ‘Externalizing’ where the problem is considered as an entity with a life of its own and analysed to discover how it was born, is currently maintained, is strengthened or weakened and then its ties to ‘life’ eroded and removed. I often feel that he must have taken inspiration from Chinese works like Sun Tzu‘s Art of War which has a similar strategy. Both involve gathering intelligence on a problem first including all its contributing factors and then manoeuvring yourself into a position where those influences are so weak, or even overcome and turned to your advantage, that the main problem must surrender without battle. It is often said to be as much a book of triumphing over personal demons as a manual of military strategy. Again it is metaphor used to convey ideas so abstract it has been applied to business, politics, bodywork and psychology as much as war.
General Themes of the Meridians
Before I get into the individual meridians themselves, I feel like an introduction to some of the general groups is in order to understand better how the archetype is derived. The first thing we notice about the meridians is that they can be divided into a few simple groups: those on the arms vs. those on the legs, and those on the outside of the body vs. those on the inside. Those on the legs can be seen as representing our ability to move and go places, while those on the arms can be said to have influence over our ability to touch and discriminate. The meridians on the outside, all of which are Yang meridians are associated with physical, external movements and cover nearly the entire musculoskeletal system. They also represent our ability to make judgements and initiate the physical movements to enact our choices. Those on the inside are the Yin meridians and they imply our ability to absorb, connecting with our world, ourselves and others, walking our path in life and using our experiences. Thus the arm Yin meridians can be said to represent our ability to touch and connect, the arm Yang meridians our ability to discern and sort, the leg Yang represent our ability to react or respond, and the leg Yin meridians our ability to absorb into our lives and choose our direction for our own development. These can be paired in two ways, either with its respective meridian on the same limb, which is known as their internal/external or elemental pair, or the meridian on the other limb that shares its same Yin/Yang quality which is known as its six divisions pair.
Another way we could look at these is in the Buddhist terms of the five aggregates. These are: 1) form and the sense organs that detect forms, 2) feeling as either pleasant, unpleasant or neutral, 3) perception or apprehension in cognitive awareness, 4) inclinations such as emotional reactions and prejudices that give us the impression of wholesome, unwholesome or neutral, and finally 5) consciousness or cognizance (Thompson, 2014: 320-321). The first two, the arm meridians, happen before cognitive apprehension or perception and the second two, the leg meridians happening after. While I am sure that there is a connection between the Buddhist aggregates and this system, the meridians were defined before the influence of Buddhism in China and so the influence may have gone both ways. I have elected to go with terms that are more generic and less psychological as it is difficult to imagine an organ or a river as having inclinations or being cognizant, but it is possible to see one as having defined boundaries or absorbing its surroundings into itself. This is because Buddhism is a very metaphysical system that focuses heavily on the psychological which has probably contributed to modern Taoist practice becoming mysticized and removed from the body too (Schipper, 1993:192-194). I feel that the true core of Taoist teachings remains in the body and that this embodying of the philosophy is essential in making it pragmatic.
Each set of these two pairs, one arm Yin, one arm Yang, one leg Yang and one leg Yin, makes a complete cycle, of which we may notice there are three. These correspond to one for each of the three levels of survival, interaction and differentiation, as Yuen (2004) divided them in his lecture on the Luo. These three groups can then be applied to each metaphorical system including those that do not use biological terms such as some of those in Neidan alchemical practice. In this instance survival would indicate the basic equipment, the metal and earthenware vessels, the bellows to control the fire and the raw material without which the process could not continue or even begin; interaction the heating of the solutions, the melting of the ore in metallurgy, or the mingling of opposites (fire and water) to extract the pure Yin and Yang; while the differentiation aspect would cover the extraction of final material, the forging of the metal giving it shape and identity, or the nurturing of the embryo to make something new and unique.
It might be tempting to replace them with biological, social and psychological, to fit with the modern idea of biopsychosocial interventions popular today but as I will show, each meridian has its physical, psychological and social aspects making this a restrictive fit and denying the meridians their fundamentally archetypal nature. It is interesting to note how in the western model we see an ascending pyramid placing the biological under the psychological which both come under the social sphere, whereas the Chinese consider humans to be fundamentally social beings who need interaction almost as much as they need food and air, before their individual psychology and personal determination are considered. This might be what the Yijing means when it says “the superior fellow first gets lost – then, later he gains a direction’ (Hexagram 2, Kun, the Receptive, in Bertschinger, 2015: 69). We could simply attribute this to the influence of Confucian morals but modern social theories would suggest it is more likely that individualism is actually the aberration. Maturana and Varela’s (1992) concept of consciousness emerging out of the increasing complexity of organisms suggests this too. Single cells gather in ever more complex and interdependent symbiotic colonies eventually forming beings in need of a nervous system to rapidly connect distant, specialised parts and interact with its environment. Eventually they develop language as they have in humans to interact more effectively, forming a new kind of symbiotic organism called a society. This ability to share ideas using language enables us to construct our individual realities too but also allows us to influence the society and world around us as well as being influenced by it. This endless, reciprocal, reflexive type of feedback is neither a straightforward positive or negative type of loop and so is known as a “strange loop” (Hofstadter, 2007). It is in this sense I prefer the term “interaction” to “social” as it should include more fundamental types of interaction such as the “social” aspect of bacteria or fungi forming a colony, maybe even the way a river or mountain shapes the environment but is shaped by its surroundings geology too, as well as less cooperative interactions we have with the outside world. It covers the Heart/Kidney axis and its Yang pairs, which would be the hypothalamic-pituitary-adrenal axis in modern terms. This is the primitive network that governs the fight-or-flight stress responses which extend beyond socialising and to our more violent interactions that may be considered antisocial or with non-human aspects of nature too.
With those considerations made clear we can move onto looking at each meridian in turn, paying close attention to the principle and its associated treatment strategies.
Hand Taiyin Lung Meridian – Survival/Connection – Connection to the World
The first meridian is the Hand Taiyin, Greater Yin meridian that represents our immediate connection the to the world. No organism can survive without respiration and this meridian corresponds to breath in humans. Touch and the skin, the other most immediate means of directly connecting with and absorbing from the outside world is also included. Both of these affect every part of our being and usually happen unconsciously unless deliberately brought into awareness.
Organ: Lung, indicating the first contact we have with the world and our most immediate connection to it. Without breath we will die in minutes and by controlling our breath we can change the way our body is functioning and the way we feel within ourselves.
Element: Metal: Contracting, reducing, autumn, west. The extraction of something precious. I questioned why the Lungs should be represented by the contracting principle when they expand to draw air in, but they reduce in the sense of extracting the oxygen from the air (Daqi in classical terms). We mostly breathe out to exert ourselves and employ our oxygen too, like the idea of the Lungs as a bellows in some alchemical metaphors where it is the squeezing that fans the fire.
Sense: The Lung traditionally includes the skin through which we touch and connect to world. Linden (2015: 1-6) has suggested this may be the most fundamental sense we have, the one of which we can hardly imagine to be without, in the fact that we refer to almost all emotional dialogue in term of feelings. Its meridian reflects this connection with its path going to the thumb, the digit most used in massage therapies for its ability to connect and the digit which gave us tool use thanks to our extraordinary ability to feel through an object as if it was an extension of ourselves. The Luo branch demonstrates this even more clearly spreading out across the palm of the hand.
Musculoskeletal: The ability to retract the arm from extension, to draw something towards us in order to take it in.
Psychological: The Po are corporeal spirits that connect us to our senses and bodily desires. Sometimes in Taoism these are portrayed as fiendish or demonic, trying to cause us harm and lead us to death by becoming lost to sensual desires that will ravage the body (Schipper, 1993: 36). In others it is the Po that desires to become manifest and results in our conception (Yuen, 2005: 26-33). Either way it is the Po that is the most earthly and Yin of the spirits and has the strongest connection to the body and its senses. Its harmful emotion is grief, when something we are attached to is taken from us is and it feels as though we have lost a part of ourselves.
In Dreams: The Su Wen Ch. 17 and the Ling Shu Ch. 43 (Bertschinger, 2015: 282-287) describes dreams “of seeing white things, of men savagely cut down and bleeding, of soldiers in battle” when the Taiyin Lung is weak and “of being fearful, of howling, weeping tears and a great disturbance” when it is full. “A great disturbance, and strange objects of iron and gold” indicate a reversal. Disturbance, conflict and loss seem to be the main themes indicating a loss of mindfulness and attachment to things, along with some elemental associations (white, metal).
Lifestyle: The ability to remain mindful. Imbalance implies too much connection to events leading to anxiety or perhaps a loss to destructive hedonism, or disconnection from life and inability to be touched by anything.
Treatment Strategies: Mindfulness based exercises focusing on the connection between breath and mind seem the most obvious. Massage based treatments are probably also important if lack of touch is an issue.
Political: The Su Wen Ch. 8 describes the Lung as the “chancellor and mentor” (Unschuld & Tessenow, 2011: 155) or “Prime Minister assisting the king” (Wu & Wu, 1999: 55). I think this represents the essence of society being communication and the power of the Lungs to facilitate speech. In a democracy this would be the people and their debates. Bertschinger (2015: 150) translates this as the “officials of communication” which would agree with my interpretation.
Touch, which also comes under the domain of the Lungs serves a very social function too, being the glue that bonds humans and many other animals together (Linden, 2015: 7-32). Perhaps it should also include people involved in healing arts, traditionally a very “hands on” profession relying on touch and connection. Even in today’s more remote and visually based medicine, the goal is to maintain our connection life, literally to keep us breathing, for as long as possible.
Environmental: Air. Clouds in The Book of the Centre (Schipper, 1993: 106). Open spaces where people can gather and connect.
Hand Yangming Large Intestine Meridian – Survival/Discernment – Maintaining Boundaries
All things need to maintain their integrity by expelling the unwanted and the next meridian suggests this principle. From single celled organisms to whole communities and ecosystems, the ability to accept what is good and reject what is bad is a basic need for survival. Its trajectory on the hand to our index finger represents the main finger we use for testing, the most sensitive for discernment but not as vital as our thumb should it experience something painful. The other end of the meridian ascends to the nose and throat to represent our ability to reject infections and smell things that disgust us to prevent us taking them into ourselves.
Organ: Large Intestine, the organ which expels waste from our body.
Element: Metal: Contracting, reducing, autumn, west. The leftover material after extraction from ore.
Sense: Smell, which rejects the unclean before it enters us.
Musculoskeletal: Radial and anterior aspect of arm, covering the ability to hold an object.
Psychological: The ability to tell good from bad sensations. Imbalance generally implies repetitive behaviours as if the experience is not being judged at all. Addiction may be included in this when it is the inability understand when to stop, or to tell that something is bad. Most addictive behaviours also trace this meridian, from hand to mouth and nose. Autistic behaviours that repeat themselves over and over and have difficulties judging dangerous or harmful situations may relate to this meridian too (Yuen, 2004).
Another aspect of Yangming (Large Intestine/Stomach) imbalance is the desire to “throw off clothes … climb on what is high and sing” (Su Wen, Ch. 30) suggesting mania, exhibitionism and extreme forms of extrovert behaviour. This suggests a role in our ability to feel embarrassment, an instinctive, bodily way of judging good from bad actions, characterised by a rush of blood to the cheeks where the Large Intestine Luo runs. It seems as though when this channel is full we feel the heat of embarrassment all the time and are no longer affected by it, then wishing to cool down we expose ourselves. Tying in with addiction and autism, these kinds of behaviours are also characterised by a poor ability to evaluate risk. The same chapter of the Su Wen says that when the Yangming recedes it produces “distress [and] … aversion to people”, suggesting the opposite: timidity, awkwardness and feeling embarrassed so easily it is hard to interact. This may also lie behind the inclusion of the Yangming among the channels to needle in instances of Dian Kuang, mania-depression in the Ling Shu Ch.22.
In Dreams: The Ling Shu Ch. 43 (Bertschinger, 2015: 284-287) describes dreams “of barren and uncultivated fields” perhaps suggesting the unclean or wasted.
Lifestyle: The ability to keep ourselves in a safe environment. Indulging in dangerous pastimes without knowledge of the risk. At the opposite end, shutting oneself off due to seeing danger everywhere as in hypochondria.
Treatment Strategies: Obviously dietary for problems of the organ. For psychological aspects education in safe and dangerous behaviours, or evaluating degrees of risk might be relevant. Exploring reoccurring narratives to discover what leads to danger would be an idea too.
Political: Sanitation officials, preventing disease entering society and removing waste. Modern health roles such as disease prevention and control would also be included in this.
Environmental: The Su Wen Ch. 8 describes this as the “Path along which the unclean is transmitted” (Unschuld & Tessenow, 2011: 157), that is sewage and drainage. The Book of the Centre describes this as the altar of the God of the Earth located in the forest of the Liver (Schipper, 1993: 106). Tu Di Gong, the Earth God of Chinese folk religion, is worshipped before the burial of deceased persons to thank him for using his land to return their bodies to the earth, indicating a different take on a similar theme.
Foot Yangming Stomach Meridian – Survival/Reaction – Acceptance/Rejection
This is our ability to take something in and decide if it is good for us or not on an instinctive level. While smell will make us reject something before it enters us, to taste we must take it in and form a conscious, emotional impression. Even if it bypasses our taste it can still be rejected from the stomach if it is considered unwholesome. This goes for abstract things too such as experiences which may also induce us to vomit, or cry, explaining why the meridian ascends all the way to the eye.
Organ: Stomach, which makes the final decision about whether to accept or reject food.
Element: Earth: The centre, stability, “Late Summer” harvest time.
Sense: Taste, the first opportunity to reject something considered unwholesome, or give us emotional enjoyment at something we want to accept.
Musculoskeletal: Anterior of the legs giving us the ability to stop after walking or running. It is necessary to pause in order to absorb an experience.
Psychological: Most knee-jerk emotional reactions. The Luo of the Stomach rising across the abdomen and onto the face and eyes indicates the feeling of “rising” common to anger, sadness, embarrassment and a whole host of other emotions (Yuen, 2004). The Yangming Luo are the most external of the Luo and together represent the first line of emotional defence against harmful experiences. The face flushing, the eyes watering, nose running, teeth gritting, even literally vomiting due to emotional turmoil are examples of the body trying to protect itself from or eject an experience. I suspect the body does not differentiate between harm from abstract forces such as experiences and physical ones like poisonous foods or dirt in our eyes.
In Dreams: The Ling Shu Ch. 43 (Bertschinger, 2015: 284-287) describes dreams “of eating and drinking” to indicate rebellion in the Yangming Stomach.
Lifestyle: Emotional fulfillment. Imbalance may present as sudden rises of emotion or loss of interest in events. Eating disorders are an obvious example of Stomach/Spleen issues on a mental level manifesting in the physical through behaviour.
Treatment Strategies: Learning to calm surges of emotion would be a good starting principle for treating this meridian. Qigong movements that trace the Stomach meridian down or visualisations that descend emotion are good for this. Meanwhile an exploration of their origins and triggers would be advisable.
Political: The Su Wen Ch. 8 says Stomach and Spleen are “officials in charge of grain storage” (Unschuld & Tessenow, 2011: 155). In modern age it would probably still be food storage and distribution, maybe the welfare system too. Consider the recent rise of food banks and penalty targets for unemployment agencies and what it has to say about the emotional health of society.
Environmental: The Book of the Centre describes the Stomach and Spleen as granaries (Schipper, 1993: 106). I see no reason to argue with this although I suggest an alternative for the Spleen.
Foot Taiyin Spleen Meridian – Survival/Development – Absorption and Utilisation
Once the process of acceptance and rejection has passed an organism can begin to absorb what is useful and put it to work. This work nurtures the organism and facilitates its growth and development.
Organ: Spleen. The traditional descriptions of the functions of the Spleen seem to indicate the pancreas is included too as it covers all our ability to absorb and utilise energy from food. Its trajectory across the abdomen indicate this as dietary deficiencies or excesses will manifest in wasting or accumulation between these lines.
Element: Earth: The centre, stability, “Late Summer” harvest time.
Sense: Energy levels. Dips in energy and inability to focus are common issues associated with the meridian.
Musculoskeletal: The movement of drawing the legs up and in towards ourselves. If both Taiyin movements are performed we end up in foetal position, the “greatest Yin” position we can have. This meridian also governs all muscle as these are what convert the energy we consume into work.
Psychological: The Yi, or attention, is our ability to concentrate and focus in order to nurture a result. It is the mental equivalent of muscle, burning up sugars to produce a result. Its harmful aspect is worry, an excessive attention to a problem, over-thinking or being unable to switch the brain off. This sort of nervousness is the kind that affects our appetite, or when we feel “butterflies the tummy” reflected in the Luo going to the abdomen.
In Dreams: The Su Wen Ch. 17 and the Ling Shu Ch. 43 (Bertschinger, 2015: 282-287) describes dreams “of eating and drinking and not being satisfied, of ramming down earth for a wall or roofing over a dwelling” to indicate weakness of the Taiyin Spleen, while dreams “of singing joyfully, the body heavy and you cannot get up” when it is full. Rebellion creates dreams “of hills, mounds and the great marshes, a hill-top house in the wind and rain”. Many of these images are about security and happiness along with its elemental earth symbolism.
Lifestyle: Diet, exercise and work seem obvious.
Treatment Strategies: Dietary and exercise advice. Advising about work balance and the causes of worry might be important too.
Diet, herbs and Qigong exercise are complete branches of medicine in themselves that can treat everything. This can be seen as either a fractal, where every meridian has every other within it, with a treatment modality associated with every meridian that can treat every other to some degree, or due to the centrality of the Stomach and Spleen from as promoted by Li Dongyuan and his Earth School in the 13th century.
Political: The Su Wen Ch. 8 lumps Stomach and Spleen in together as the “officials in charge of grain storage” (Unschuld & Tessenow, 2011: 155) but the absorbing, nurturing aspect of the Spleen makes me suggest the agricultural aspects of food growth might be more suitable. This was the basis for ancient economics and so in more modern societies marketplaces, commerce, factories, offices and workplaces may replace it: places where food is put to work in order to generate money to keep on living. This is reflected in the fact that it is still case that the least wealthy suffer most diet related problems despite the fact it is now most likely an excess of poor quality food than a lack of it.
Environment: Soil and farmland. The Book of the Centre describes it as the “Yellow Court, the body’s ritual area and meeting place of its inhabitants” (Schipper, 1993: 106), connecting it with its Taiyin pair, the Lung, about connection with talk and touch. The location of the Yellow Court in alchemical meditations, in the centre, makes me suspect further that the Spleen includes the pancreas.
Hand Shaoyin Heart – Interaction/Connection – Connection to Others
This represents our ability to connect with others and is the core of our emotional life. It occupies a position among the organs often considered sovereign demonstrating how vital social contact is for survival in Chinese philosophy.
Yuen (2005: 130-131) has said that the basic needs for survival are to breathe, to eat and to sleep. The Lungs and Spleen represent these first two basic biological needs for life, the Heart indicates the totality of all the things needed to be at peace with oneself in order to sleep soundly. This, like the comparisons to a sovereign, suggests that this has some overlap into the survival sphere, as does the nurturing aspect of the Taiyin Spleen have social connotations. In fact all the meridians overlap into the domain of their neighbours, like one continuous line that has been divided for the sake of understanding, not because they are genuinely separate entities.
Organ: Heart. In Chinese medicine the Heart is seen as much more than a pump for blood. Even Blood is seen as much more than the fluid that transports oxygen and nutrients around the body. The Heart is the seat of the Shen, the spirit, the reflective consciousness. When it feels emotion they infuses into the Blood. Emotions are generally social phenomena. Even emotions of rejection or isolation are generated from social exclusion. This makes connection to others essential to our emotional life and a healthy emotional life is essential for Heart health, reflected in the trajectory of this meridian, along the inside of the arm where cardiac pain is often felt.
Element: Fire: Rising, blossoming, summer, south.
Musculoskeletal: Along the inner aspect of the arm, giving us the ability to internally the rotate the arm, i.e. in an embrace. It also “opens into the tongue”, enabling speech and communication.
Psychological: Houses the Shen, the aggregate of all other emotional states. It’s classic harmful emotion is “joy” which I consider to be too much excitement and stimulation, not allowing the Shen to rest in repose and reflect as it is meant to. It also is damaged by betrayal, isolation and the feeling that ones voice is not heard (Yuen, 2004: 51-52).
In Dreams: The Su Wen Ch. 17 and the Ling Shu Ch. 43 (Bertschinger, 2015: 282-287) describes dreams “of putting out a fire or drying things, of a great blaze or conflagration” when the Shaoyin Heart is weak, while dreams “of being happy and laughing, or frightened and scared” when full. Reversal produces dreams “of hills and mountains, and smoke from lit fires” which connects its elemental association with the communicative role of this meridian as smoke signals are a method of communication. The outposts of the Great Wall were known to communicate through smoke signalling.
Lifestyle: Socialising. Imbalances may present as either a constant need for companionship or isolation.
Treatment Strategies: The talking aspect of therapy is probably most important in treating this meridian and people with an excess in their Heart are probably the ones who cannot calm their Shen and talk through the session anyway. Looking at why someone needs constant excitement or feels disconnected from people is probably needed to decide a course of action. Compassion meditations might be suitable for some people too. Cardio exercise might also be a good idea for physical problems.
The Tao Te Ching Ch. 17 (trans. Pine, 2009: 34) says that the greatest lords are ones who are only known to exist and exert no overt influence on the people, the next best rule with kindness and justice and so are loved and praised, the worst are feared and despised. The Heart in both physical and social-psychological realms are functioning best when unnoticeable. When we experience a problem we become aware of it and the next best thing is to be kind: modifying our diet and engaging in moderate exercise for physical health or evaluating our emotional lives to restore our ability to love and accept praise for the psychological element. When it fails we feel fear and oppression, in both the crushing panic of a physical heart attack or the fear of society that leads to isolation and resentment of our exclusion.
Political: The Su Wen Ch. 8 says the Heart is the “Ruler” (Unschuld & Tessenow, 2011: 155), “Monarch” (Wu & Wu, 1999: 55), or “Lord and Master” (Bertschinger, 2015: 150). The ruler directs all other aspects of the kingdom so if the ruler is unbalanced then all under them will suffer.
Yuen (2004: 52) describes the political situation of a people feeling so frequently betrayed that they do not believe that their voice matters and stop engaging with society as a symptom of a nationwide imbalance in the Heart Luo.
Environment: In nature the Sun. The Book of the Centre describes it as “a large dwelling, coloured bright red … [a] Scarlet Palace” (Schipper, 1993: 106), presumably the dwelling of the ruler.
Hand Taiyang Small Intestine – Interaction/Discernment – “Separating the Pure from the Impure”
The classic function of the Small Intestine is to “separate the pure from the impure”. This refers to the ability to tell good situations from bad ones, much like the hand Yangming Large Intestine does with the environment through discriminative touch, except with our interactions with others. Many of the points on this meridian are related to “releasing Heat from the Heart”, that is agitation and emotional disturbance.
Organ: Small Intestine. Separates and absorbs what is nutritious (pure) from that which must be passed on to the Large Intestine as waste (the impure).
Sense: Hunches. Intuition regarding people and social situations.
Element: Fire: Rising, blossoming, summer, south.
Musculoskeletal: The ability to extend the arm, to reach out for something or push it away.
Psychological: The ability to decide between what is good and bad, to accept helpful experiences and reject the unwanted ones, especially on the social and emotional level. The ability to accept praise and feedback are indicated by this meridian too with imbalance often being a constant seeking of approval (Yuen, 2004: 52). In TCM its points are mainly used to release Heat, usually from negative experiences, from Heart.
In Dreams: The Ling Shu Ch. 43 (Bertschinger, 2015: 284-287) describes dreams “of gathering on the busy highways” indicate reversal in the Taiyang Small Intestine meridian. Gathering suggests a sorting and separating and busy highways indicate a social place.
Lifestyle: The ability to decide between good and bad people in order to create a supportive social circle. Imbalance may present as falling in with “the wrong crowd” or enduring “toxic” relationships, possibly through an excessive need for praise and inability to accept rejection. The reverse of being over cautious and not letting people in at all might indicate this too.
Treatment Strategies: Analysis of enduring patterns would be good advice in treating lifestyle imbalances involving this meridian. Similar to Yangming Large Intestine, exploring life narratives to see where the reoccurring patterns begin would be a suggestion.
Political: The Su Wen Ch. 8 says the Small Intestine is “the official functioning as recipient of what has been perfected. The transformation of things originates in it” (Unschuld & Tessenow, 2011: 157) and comments that Kong Yingda explained this meant the “realization of plans completed by someone else”. Bertschinger (2015: 150) translates it as “officials in charge of ‘receiving fullness’. The transformation of materials is their duty”. These rather cryptic descriptions lead me to think that as the outer Yang meridian paired with the Ruler/Heart, it refers to lesser civil servants where the king’s will is realised. In modern society where state control is more diffuse and privatised it may represent all offices and bureaucratic systems where the government policy is enacted.
Environment: Personal dwellings where walls and doors “separate the pure from the impure”, the inside from the outside. Town and city boundaries may be seen to do this on a larger scale. The Book of the Centre describes it as the altar of the God of the Harvests, located in the forest of the liver (Schipper, 1993: 106), perhaps containing similar overtones of a region of civilization in the wild, or the harvest as a time when the nutritious is reaped and the chaff discarded from the crops.
Foot Taiyang Bladder – Interaction/Reaction – Ability to Move Forward
The Taiyang, “Greater Yang” meridian is mainly about being able to stand up and walk or run. This is a more important definition than its organ as it has little or no relation to the Bladder and would be better defined as the “outer Kidney” i.e. the adrenals and alarm response (Yuen, 2004: 53). It is possibly one of the most common meridians seen in clinical practice as it covers the back, knees, neck and shoulders which acupuncturists see all day long. It is also a great example of how the meridians can be seen as a mirroring different levels. The common pattern of tight shoulders can be seen when someone has carried a heavy backpack a long way but is also seen in people under stress. They are carrying a load in their mind and the body is acting the same way as if they were carrying the backpack. Tight calves are also common in stressed clients and may suggest a desire to run away. If someone constantly feels under threat and are preparing to run then over time their constantly prepped calves will become short and tight. Another way in which it may be viewed as the “outer Kidney” is in that it covers the back Shu points – it is the outer, accessible place where we can tap into the deep, internal level.
Organ: Bladder. As mentioned above it probably relates more to adrenals with only a couple of points influencing urination in any way. Extreme fear may cause a spontaneous bladder release though.
Element: Water: Sinking, storing, winter, north.
Sense: Danger. Fight or Flight.
Musculoskeletal: Extension of the legs and spine. The ability to stand up, pick up a weight and walk or run forwards. The Sinew branch also includes branches that go over the shoulder and across the jaw which we often tense when under strain.
Psychological: Adrenal response. Not harmful in itself but will become harmful if it cannot switch off. Symptoms of being constantly on the alert, permanently anxious, or the opposite and having a complete shut down, being unable to feel fear, even seeking out dangerous situations might indicate an imbalance here. Its Luo branch runs up to the diaphragm which is often tight in fear-stressed people while its sinew branch covers many areas where muscles tighten under stress.
In Dreams: The Ling Shu Ch. 43 (Bertschinger, 2015: 284-287) describes dreams “of travelling on or fording streams” connects this meridian’s elemental association of water with its role of moving forward.
Lifestyle: Stressful environments, both physically and mentally. A manual labourer and a company director would both probably have problems in this meridian.
Treatment Strategies: Exercises to release tension from legs, back and shoulders for physical meridians. Stress reduction, especially diaphragmatic breathing due to Luo pathway leading to the solar plexus are probably good management tips for the emotional side.
Political: The Su Wen Ch. 8 describes this as the “office of gathering, it stores the water and fluid” (Wu & Wu, 1999: 56) perhaps indicating the important job of managing water reserves and reservoirs. This is perhaps the most vital job for the survival of a community as either flooding or drought spell disaster for the people. In the modern age this would indicate other high stress jobs who carry heavy loads. Even if their job is not life-or-death stuff, they may perceive it to be.
Environment: Reservoirs and places where water is stored.
Foot Shaoyin Kidney – Interaction/Development – Path through Life
This meridian implies the changes and development we undergo as we grow, from childhood through puberty to adulthood, reproduction and parenting, to ageing. It governs water and represents the course of the river, from emergence as a spring to dispersal into the sea. A lot of problems relating to this meridian are signs of ageing and not the kind of thing that can be ‘cured’ so treatments relating to this meridian are often about acceptance (“The best are like water … moving with time”, Tao Te Ching Ch. 8, trans. Pine, 2009: 16). Some modification of lifestyle may be possible to help us cope better too.
It is grouped in the ‘interactive’ part of the trinity because these roles such as child, adult, parent, grandparent and senior are largely conferred upon us by society when we reach certain ages or stages in life. Like with the Heart which flows smoothly on from and incorporates elements of the ‘survival’ aspects, this meridian flows into the ‘differentiation’ meridians as these socially conferred roles often affect our sense of individual identity too, a topic explored more fully in the next meridian, the Jueyin Pericardium.
Organ: Kidneys. The management of water metabolism was just one of their physiological functions and mainly connected to the fact that the waterways come out from the genitals. Instead their main function in the body was the storing of Jing, essence, that was necessary for growth, development, reproductive functions and whose loss caused premature ageing.
Element: Water: Sinking, storing, winter, north.
Sense: Hearing. This declines over time with little possible treatment.
Musculoskeletal: Governs bone. Bones were seen as the rocks and mountains of the human landscape, the immovable and constant features around which other things attach and define their positions. Age also tends to produce an almost inevitable degeneration in bones in the forms of arthritis and osteoporosis. The Sinew meridian also commands the ability to rotate the leg while flexed, as in sitting cross legged.
Psychological: In psychological terms the Jing makes up the other half of Jingshen, consciousness. I argued previously that if Shen was the observer, Jing is the phenomenal essence of the thing observed, including perhaps our own body.
The Zhi or Will is said to reside in the Kidneys also. This is the power of determination, to persist over time. It differentiates itself from Yi, Intent, with regards to its persistence. The counterpoint to Will is fear making this the harmful emotion for the Kidneys. In pathological states obsessive-compulsive disorders may result, as an example of attempting to overcome perceived fears using pure willpower, or paranoia as a persistent fear about interactions with society (Yuen, 2004: 54).
Memory, also an ability that spans time and declines with age is placed under the domain of the Kidneys.
In Dreams: The Su Wen Ch. 17 and the Ling Shu Ch. 43 (Bertschinger, 2015: 282-287) describes dreams “of boats and drowning people, of being submerged under water, perhaps of being scared and terrified” when the Shaoyin Kidney is weak, while rebellion produces dreams “of being at the brink of a steep cliff, of being lost or drowned in rivers” all suggesting being overcome or powerless against the course of water which is a recurring theme of this meridian. Fullness produces dreams “of waist and back being both loose and disconnected” which seems quite an unusually physical image, perhaps because the Kidneys are rarely ever Full except when describing musculoskeletal problems. Normally fullness of Kidney Yang or Yin is seen as a false sign due to the relative emptiness of the other.
Lifestyle: Major life changes and landmark points that define the structure of life. Problems are likely to involve an inability to accept the passage of time and adopt a new role in life.
Treatment Strategies The goals for much of this meridian are likely to be acceptance and accommodation of changes and new phases in life. Ideas from occupational therapy and social work might be suitable to adopt, evaluating which of their social roles they need help with and modifying the environment to make the pressures on them easier to bear. The Kawa River model (Duncan, 2011: 117-135) seems especially appropriate to this meridian and clearly derived from an oriental meridian model. Bertschinger (2015: 73) cites a ‘lost chapter’ from the Su Wen that encourages meditation (discussed more below).
Political: The Su Wen Ch. 8 says they are people with “technical skills and expertise” (Unschuld & Tessenow, 2011: 157), craftsmen whose experience can sculpt and shape the land and harness natural forces.
In modern times, when crafts are practically extinct they may represent teachers and others in education who guide and train the young with the skills they need on their path in life. Priests and spiritual leaders would also come under this bracket.
Environment: Rivers, mountains and fixed points on the landscape. The Book of the Centre describes them as the Sun and Moon which “cast their light on the great Ocean of Energies (Ch’i-hai), which covers the whole of the lower body” (Schipper, 1993: 106).
Foot Jueyin Pericardium – Differentiation/Connection – Expression of Self and Ability to Protect Individuality from Threat
Now we move onto the aspects of differentiation or defining ourselves as individuals. The first is the ability to connect with our Self and protect it from becoming overwhelmed by socialising influences. The aspects of social conditioning we reject may very well be where our sense of being different to the rest of society comes from but it is also important for us to function in society meaning it needs to be able to tolerate doing what is not in our nature in order to preserve our nature. For this reason it takes on the form of a defensive barrier to our Heart making many of its medical applications seem indistinguishable and often interchangeable. In some traditions this meridian is always treated instead of the Heart directly as all disturbance of the Heart is seen as an inability of the Pericardium to protect it. Others use the Pericardium for psycho-emotional disorders while the Heart is used for physical cardiovascular disease. Both have their merits but I prefer to see them as different but closely related meridians. I would probably suggest that if an issue has gone as deep as the Heart with signs of total isolation or heart disease then its probably necessary to treat both in order to protect what you have restored.
Now we are in the last trinity we can compare the three ‘connection’ meridians: Taiyin Lung and skin connecting us to the world with touch, Shaoyin Heart allowing us to be connected to others and Jueyin Pericardium, connecting us to our differentiated selves by protecting us from being overwhelmed by social influences.
Organ: Pericardium, the Heart Protector.
Element: Fire: Rising, blossoming, summer, south.
Sense: Propriety. The Pericardium enables us to store our emotions for release at a more socially acceptable time.
Musculoskeletal: The Jueyin meridians tend to indicate resting and stillness. Pain related to the Jueyin is usually not alleviated or aggravated by any movement but present all the time.
Psychological: Its main duty is to shield the Heart from harmful experiences. This deflecting allows us to cope with hurt until we can redirect it somewhere else. Imbalance is indicated by a loss of control this function, bursting out an inappropriate times, threatening our individual progress in life, while Heart imbalance would represent an disconnection from other people and society.
In Dreams: At the time of the Nei Jing the Pericardium was not seen as separate from the Heart so no individual dreams are given.
Lifestyle: Gives us the ability to cope with criticism, disappointment and frustration. Imbalance may indicate a reduced ability to cope with these or a complete disregard for them.
Treatment Strategies: Developing coping strategies and finding safe outlets for harmful emotions is good advice for this meridian, although beware of encouraging catharsis. Modern evidence does not support catharsis as reducing negative emotion, but on the contrary reinforcing the behaviour, so finding constructive ways to direct feelings may be better than getting a punch bag.
Political: The Su Wen Ch. 8 says this is the “Messengers” (Bertschinger, 2015: 150) and “Envoy” (Unschuld & Tessenow, 2011: 156) transmitting the “joy and pleasure” of the emperor to the people, while protecting the emperor from harm by avoiding direct contact with untrusted people in the process. In modern society the media fulfils this role, conveying messages to the people at a distance. Harmful messages from the media can often damage people’s self-image resulting in psychological distress relating to this meridian and others.
Environment: No environmental description is given for the Pericardium, it usually being encompassed by the Heart as sun. I would perhaps suggest the moon as the reflection of the sun, especially considering the moon’s influence over water and the pericardium’s relationship to the triple burner which is often described as an “irrigation ditch” network. The Book of the Centre describes a sun and moon in each realm, as the eyes in the head, the breasts in the chest and the kidneys in the abdomen (Schipper, 1993: 106) which would also imply the moon should be represented by something with similar properties to the sun.
Hand Shaoyang Sanjiao / “Triple Heater” – Differentiation/Discernment – Self-Creation
This represents the capacity for self-examination and to actively create ourselves through our actions. The Shaoyang meridians indicate choice in movement, being located between the Taiyang (extending, advancing) and the Yang ming (stopping, holding). Therefore this meridian’s trajectory on the outside of the arm indicates being able to actively choose our actions, manipulate objects and through our actions generate our identity. This position between opposites is taken even further with its elemental association with fire but repeated references to water in other metaphors making this an important meridian in Neidan alchemy and self-transformation as it implies the uniting of opposite forces to conceive something new.
This organ is translated as different things having no direct equivalent in English but is often considered to be the endocrine-immune system which controls body temperature. Compare this with the other ‘differentiation’ meridians: the Yangming Large Intestine which also has an immune component, going to the nose and throat and being about defining our physical boundaries and rejecting the unwanted, the Taiyang Small Intestine, which separates the good from bad influences that shape our social environment, while the Shaoyang Sanjiao allows us to accept and reject the things we want to be in ourselves.
Organ: Sanjiao, literally “Triple Burner”. Its descriptions are often paradoxical such as “the organ with a name but no shape” and features heavily in alchemical literature. Sometimes it is considered to be the meridian network, at other times interstitial spaces and the main cavities in the body. In terms of traditional medical usage it often used in infectious disease to boost immunity or calm temperatures suggesting the endocrine-immune systems which have no single location in the body. The immune system is the biological component that actively seeks out self and non-self in order to maintain our internal integrity.
Element: Fire: Rising, blossoming, summer, south.
Sense: Internal temperature. This is again important in Neidan meditations where body temperature is said to rise, similar to the Tibetan practice of Tummo. Eva Wong (2004) describes several instances of this among legendary Taoist masters.
Musculoskeletal: The ability to rotate the arm instead of just reaching out.
Psychological: Very important in alchemical practices which were concerned with the creation of a new self. In everyday psychology it is important in creativity, self-examination and individuation. Imbalance may indicate an inability to change our ways, stubbornness and rigidity, or a total focus on self-satisfaction with indifference to how it affects others.
In Dreams: The Nei Jing does not provide any dreams associated with this meridian either.
Lifestyle: Creative pursuits and the flexibility to find innovative solutions to developments in our lives.
Treatment Strategies:Encouraging creativity through art, music, writing or anything that appeals to the person might be a good means to explore psychological issues on this meridian. I often think more imaginative people respond better to acupuncture, perhaps because they understand how much impact an piece of stimulation can have on a person and expect more, so encouraging artistic pursuits might be a good way to make treatment more effective when we experience a block.
Political: The Su Wen Ch. 8 says this is the “opener of channels. The paths of water originate in it.” (Unschuld & Tessenow, 2011: 158). I take this as those in charge of irrigation, getting water to where it is needed. These enable a society to define itself through creative action instead of being at the mercy of where nature has placed water sources.
In the modern world this may also indicate transport and communication industries, who “irrigate” society with people and information instead of water.
Environment: The obvious environmental feature to relate to irrigation officials would be irrigation ditches. If we accept transport and communication as extensions of this then canals and roads too.
Foot Shaoyang Gall Bladder – Differentiation/Reaction – Inspiration and Courage
If the previous meridian is about creating ourselves with our actions, this one is about finding and taking the path we need to be true to ourselves. This is not a rational meridian but a reactive one and so it indicates the non-rational elements of deciding: the light bulb moments when a new path becomes apparent to us and having the courage to take the plunge. The reflecting and reasoning aspect belong to the following Liver meridian. It is also the aspect of ourselves that decides which path to take based on moral considerations. Morality is usually emotionally judged rather than ethics which is a rational, philosophical pursuit.
Again we can see a connection between the ‘reactive’ meridians: the Yangming Stomach being about basic emotional responses, the Taiyang Bladder being about stress responses to our environment and the Shaoyang Gall Bladder being about making gut decisions to develop ourselves.
Organ: Gall Bladder. Like many Yang meridians its association with its organ is often tenuous and is better seen as the movement that corresponds to its Yin pair, the Liver.
Element: Wood: Expansive, sprouting, spring, east.
Musculoskeletal: The ability to turn and change direction. Its Sinew path is located mainly along the sides of the body with a branch notably connecting the sacrum for turning at the hips.
Psychological: Inspiration and courage, as described above. Imbalance may present as timidity, struggling to make changes or a feeling of being trapped with no options. Its Luo path onto the dorsum of the foot indicates this “itchy feet” feeling of wanting to move on.
In Dreams: The Ling Shu Ch. 43 (Bertschinger, 2015: 284-287) describes dreams “of conflict and self-harming” when reversing qi is lodged in the Shaoyang Gall Bladder. Conflict implies a disagreement in the possible options available and Yuen (2004) discusses how pathology of the Luo of this meridian may result in self-harm, self-neglect or even suicide when no options appear available.
Lifestyle: Inspired change. Having options and the confidence to take them. Situations that seem hopeless will affect this meridian.
Treatment Strategies: The aim of treatment should be to seek new options through lateral thinking. This can be one of the most frustrating meridians to treat as there is no real way to make inspiration happen, especially if the person is stuck in a routine. I might suggest trying to encourage some new pursuits of any kind, hoping that inspiration might come from an unexpected direction if the option is made available, such as meeting new people, discovering new interests, or going to new places.
Political: The Su Wen Ch. 8 describes this as “an impartial judge who makes one to judge what is right and what is wrong” (Wu & Wu, 1999: 55). They are therefore the judges, lawyers, courts and institutions of justice.
Environment: The Book of the Centre describes a “Purple Chamber, which is the place of retreat, the silent room adjacent to the ritual area [the Yellow Court/Spleen]” (Schipper, 1993: 106). This is a place of meditation where one can silence the mind to find new solutions to problems.
Foot Jueyin Liver – Differentiation/Development – Hopes, Dreams and Plans
Whereas the previous developmental meridian, the Kidneys, were about the inevitable changes we have to face in life, this one is about the ones we choose for ourselves. It is often used interchangeably with “stress” in modern practice but it should represent a particular kind of stress, when the person we have become is mismatched with the one we see ourselves to be.
Finally, if we compare the ‘Developmental’ meridians we can see the Taiyin Spleen about how our body builds us out of the food and work we do, the Shaoyin Kidney about how society defines our roles based on the major landmarks in our passage through life and the Jueyin Liver about how we build our individual destinies with our own hopes, dreams and plans.
Organ: Liver. The liver literally metabolises and detoxifies our body, creating the things we need and breaking down those we do not but many of its associations are to do with its housing the Hun, the ethereal soul, who plans, witnesses and records our lives.
Sense: Sight. The Hun resides in the eyes during the day, recording what we see, and rests in the Liver at night (Yuen, 2005). Insomnia or vivid dreaming may be result of its refusal to rest and so staying in the eyes.
Element: Wood: Expansive, sprouting, spring, east.
Musculoskeletal: Along the inner thigh. As with the other Jueyin meridian it is indicated in pain that will not cease.
Psychological: Stores the Hun, mentioned already, which foresees a story where our life should go and who we feel we should be. It is therefore most often connected with frustration and anger although also in sexual dysfunctions, especially when we are not being faithful to our self in order to fit with societal expectations. This is shown in the path of the Luo to the genitals.
Daydreaming and escapist behaviours like some forms of addiction are also aspects of wanting to be in a different life. In severe cases this may become a disassociation disorder such as schizophrenia or multiple personalities where the self has become divided and distant.
In Dreams: The Su Wen Ch. 17 and the Ling Shu Ch. 43 (Bertschinger, 2015: 282-287) describes dreams “of mushrooms and moulds, the fragrance of fresh grasses, crouched under a tree, not daring to get up” all suggesting the association with plants, while the last suggests the desire of the Hun to extend itself. Fullness produces dreams “of being angry” suggesting the frustration of a life that is not going the way we envisioned it to go. Rebellious qi gives dreams “of mountain forests, woods and great trees” with more plant analogies.
Lifestyle: The ability to make life choices that accord with who we perceive ourselves to be. If we feel disassociated from our situation it will lead to problems in this meridian.
Treatment Strategies: Exploring and reconnecting to our sense of self, finding who we dream to be and trying to realise it would be the main aims of treatment. Visualising who we want to be and planning what steps it takes to get there would be a good accompaniment to this meridian. The “Miracle Question” in Solution Focused Brief Therapy could be suitable here if behavioural change is all that is needed.
Political: The Su Wen Ch. 8 says this is a “General” who engages in “planning and deliberation” (Unschuld & Tessenow, 2011: 156). The military plans for the future of the country in the same way an individual seeks to create their own future.
Environment: Trees and plants. Wood is the element which expands, growing up and spreading roots through the earth. The Book of the Centre describes this as a forest (Schipper, 1993: 106).
Uses for the Archetype-Metaphor Model
Is this of any use or am I just entertaining myself by drawing associations between various books I have been reading? The latter is certainly true but I believe it has been helping my practise in a few key ways. It has helped me to answer that ubiquitous question that every client asks: “so how does all this work then?” in terms that not require me to alienate myself with talk of magic energies. In doing so it has also simplified my diagnostic procedures while enhancing the scope of my treatments by making bridges between physical signs, mental processes and lifestyle factors more apparent. This has made it easier to suggest which areas of lifestyle changes or exercises I wish to pursue in relation to each meridian. Finally, it has helped me to understand some of the more esoteric descriptions in classical texts where a literal translation seems bizarre or absurd.
Perhaps the most useful is the ability to explain to clients what I am doing and how I am planning to do it. This is especially true of internal treatments, where needles are left in and the patient encouraged to rest for a while as this is the most mysterious to western minds and probably also the most common style of treatment taught and practised in the U.K. Instead of resorting to magic-speak I can explain that it is to focus them on the issues raised in the consultation and tailor the consultation to the meridians I intend to use. Then I can quickly explain the reasons for me using a particular meridian (“we spoke about how you feel disconnected which is why I have a point on the hand”) and it does not seem so strange or worrying as it does to indicate that I am treating their heart or lungs. Once the explanation is complete I often encourage them not to think about the issues directly as that promotes a tendency to find a line of thought and follow it when we often want new ideas to come forward. I explain that the needle sensation should help direct their mind towards the areas we want to deal with while they just watch the thoughts rise and fall. I sometimes compare it to watching fish in a lake at night with a spotlight: if we follow a single fish with our light we will be unaware of what others are in the lake. By casting the light dispassionately across the whole lake we may see others we did not notice before. In simpler treatments I might just be asking them to focus on their diaphragm and learn how it moves so they can breathe deeply and feel the effect it has on their mind with a view to training them to do it without the needles. In those cases the points will teaching tools, to induce relaxation and make them feel where their diaphragm and the area they are trying to draw it down to actually are. In my ideal treatment there should be no point that is not being used for a reason that seems obvious to both of us. When there are I suspect I may be resorting to the the esoteric in an attempt to disguise my own floundering.
The next important way this has changed the way I practice is by simplifying my diagnostic procedures while expanding my treatment options. Instead of a complex TCM pattern that tries to account for every symptom they describe, I can identify the areas of life that are affecting them most through their main presentation and decide on one or two meridians to work on with a simple differential process. That process would be: does it relate to their basic biological survival needs, their interactions with others or their ability to differentiate themselves, then does it relate to their ability to connect on that level, discriminate good, bad and neutral input, their reactions to things, or the processes they use to develop themselves. Then I can consider if that area seems weak (Xu) or excess (Shi). This helps me “seek out the root” instead of becoming lost in the “ten thousand loose things, all tangled and confused” in their complete presentation (Li Zhongzi in Bertschinger, 2015: 192). There can certainly be more than one meridian involved but I try to keep it fairly simple and if there is too much information, just try to find the one or two meridians, preferably related by six divisions or Wuxing dynamics, that will make the most difference to all the others. This helps with keeping intention focused on a single change that I can inform my clients of and how the treatment is supposed to facilitate this. It also makes the treatment more like a meditation on a meridian with a theme attached to it or the relationship between two where I think acupuncture developed from, rather than a series of disconnected points with special actions as is often presented in modern TCM manuals.
I am also able to scale the same meridian up or down to find out at what level it is being affected and what we can do about it on a realistic level. For example, if someone comes with eczema we can quickly place it under the Taiyin Lung meridian which governs skin and suggest breathing based mindfulness exercises to reduce the stress component while looking at whether it may be caused by contact allergy (Taiyin Lung alone), ingested allergy (with Taiyin Spleen) or inherited (with Shaoyin Kidney) and take the appropriate measures to control with diet or adjust our social roles to minimize the impact. We can also consider how it might impact our sense of self-identity (Jueyin Liver, controlled by the Lung on the Ko cycle). The actual treatment is then a means to facilitate whatever changes I want to them to do, either teaching exercises, developing mental skills, or giving time and a physical reminder to focus their mind on solving a problem area.
One idea this system of levels has helped me understand is one often cited in the study of collateral meridians that if we treat the superficial Sinew meridian incorrectly then we may drive the problem deeper and cause a retained pathogen on the inside. Often this takes the form of having to insert a needle into the primary meridian to “protect” it or being cautious of our needling depths in case we drive a surface pathology deeper. This has often concerned me has being a load of nonsense. The single argument that saves acupuncture from most criticism is the fact that it is the safest kind of therapy you can receive with no evidence it can create serious problems as long as needle technique is safe and hygienic. But in looking at the meridians from the point of view of a principle manifesting on many levels I have come to realise a better way to understand this is the notion that we could treat the superficial without looking at the deeper causes that may be generating the problem, enabling it to develop and grow. For example, if a person is coming for a tight neck and shoulders and we relieve their pain repeatedly without looking at why it might be manifesting on the psychological level or in their daily behaviours then we are allowing a pathological pattern to “go deeper”, become reinforced and harder to break. It may be advisable then to consider why they keep returning and do a deeper level treatment to find a more permanent solution or at least bring the matter up for discussion.
Adding these levels brings more depth to the diagnosis process, but still keeping it a simple expression of intent rather than the proclamation of a universal truth on the internal state of their anatomy. Which meridians and areas of life are we going to work with? Is it an external, superficial, musculoskeletal problem or at the internal, psychological and lifestyle level? Add in whether we think it is excess or deficient and whether we find signs of heat or cold and we effectively have an “8 principles” diagnosis. Keeping things at a general level without copious amounts of internal pathology and precise descriptions will probably enable clinicians to agree with each other more often too.
This was debated in Oddveig Birkeflet’s presentation at the Acupuncture Research Symposium regarding whether we could rely on TCM diagnoses. Her conclusions were that inter-practitioner agreement on specific syndromes was low, with rates barely higher than chance but when they were grouped together in more general categories such as “Liver + Excess” they improved and improved even further if just the meridian or Zangfu organ was taken on its own. This is hardly surprising as agreement is bound to reduce the more precise people attempt to be, especially in a system that is as fundamentally subjective as Chinese medicine. This means I now quite frequently write down things like “Liver excess” without worrying about whether it is Qi stagnation, Yang rising or Fire blazing. I can fill in the blanks later if they become apparent but the main thing I need to know, that their sense of individual development is frustrated and needs to be reconnected, is all short-handed in those two words. I can then think of how best to achieve that in relation to the person who is in front of me and the history they told me.
Another way this view has helped me is in reading the classical texts. Classical systems were nowhere near as unified as the modern system of TCM would suggest and when reading the Neijing I often find curious references that have left me puzzled. For example, when treating mania I looked up chapter 22 in the Ling Shu on Dian Kuang or “Mania-Withdrawal”. It makes frequent reference to treating the Taiyang, Yangming and Taiyin meridians with no mention of the Heart or Pericardium usually used as default in all psychological disorders. Of the people I have treated relatively few have suffered lung, digestive or bladder complaints (although a full thirst seems common which is sign of Yangming Stomach Fire), so I pondered what this may mean. Taiyang indicates movement and adrenaline while Yangming and Taiyin cover the whole survival aspect of the first meridian circuit. What it seems to be implying is that survival instincts are working overtime. Adrenaline (Taiyang Bladder), rising emotions (Yangming Stomach) and problems recognising harmful situations (hand Yangming Large and Taiyang Small Intestines) all seem to be common problems, as is the ability to utilise resources properly, remain focused and process stimulation (Taiyin Spleen & Lung). Physically there is likely to be tension in the jaw (Yangming) and across the back (Taiyang). It seems the Ling Shu authors were correct if their intention was observe which aspects of life are affected and how they are mirrored on the living person. An outline of treatment may therefore be to promote mindfulness to situations, usually initiated by observing the breath, and exercise to direct additional energy, especially if it requires focus and attention. Sessions teaching or encouraging these can be combined with analysis of thought and behaviour patterns to promote an understanding of these areas of life, actual physical treatment aiming to facilitating these.
A second example where using a broader and less anatomical definition of the meridians has helped me understand a reference in classical literature comes from a passage from one of the Su Wen‘s ‘lost chapters’ cited by Bertschinger (2015: 73):
“When the Kidneys have been ill over a long period,
You must face south an hour before dawn.
Clear the mind, not allowing any unruly thoughts
And stop up the breath, seven times in all.”
It seems like odd and impractical advice to meditate before dawn to cure kidney or urological disease and even if we extend the definition to all its Zangfu associations it takes something of a leap of faith to believe it can grow hair where it has gone bald, restore teeth that have fallen out and cure infertility. Arthritis might be helped if meditation can reduce inflammation but then why just the Kidneys and not state “For Heat disorders” instead. If we consider it to mean ones path in life has been assailed by many ills then it makes complete sense. What else is there to do when one’s life has taken many bad turns for which there was no recourse to action? Meditation might help to find peace, accept the inevitable and prepare for the day ahead as best as possible.
Various therapeutic disciplines have borrowed their ideas from oriental philosophy and in doing so tried to push acupuncture further out into the periphery until it is so decontextualised that it becomes a bizarre attempt to perform a sort of energetic surgery. This is an approach many modern schools have fostered in their attempt to divorce acupuncture from it’s religious background. Yet medicine is nothing more than applied philosophy. Philosophy asks what life is and what it is for, medicine uses those ideas to help those who are struggling. When viewed in the context of the Su wen we see acupuncture was just one part of a philosophy where people were seen a reflection of their world with the aim being to rebalance these factors. As the body is the crossroads where all these levels of reality meet, acupuncture was being employed as a means to draw our attention to a point that was filled with meaning in order to begin the process of rebalancing through the subsequent changes we made. If it is separated from that context it also loses many of the components which make it rational and meaningful. Getting people to understand this instead of selling acupuncture as a means to fix anatomical displacements might go a long way to getting traditional acupuncture better accepted. We might even get people to come to us for more than just the process of being poked, just to talk and discuss changes they need to make. Identifying a point that needs attention can happen on more than just a physical level.
I remember a radio broadcast on acupuncture where a western physiotherapist promoted her “dry needling” and took pains to make clear the distinction between the “scientifically valid” needling of trigger points like she performed and the superstitious nonsense pedalled by traditional acupuncturists. In fact, in light of recent evaluation of the trigger point phenomenon it seems her acupuncture was both logically and empirically flawed (Quintner, Bove & Cohen, 2015) while the very context that made traditional acupuncture “superstitious” is precisely the one that is inspiring research by modern systems biologists and “omics” medicine (Sanders et al, 2014). Ultimately, what has to come from this research is not more expensive machines and drug dependence but cheap, simple methods of guiding large numbers of the population into preventing or managing chronic conditions into old age. These should all fit within the remit of what an acupuncturist can do, something few other professions with their narrow focus on either the physical, mental or social realms can really claim, but it is also up to the acupuncturists to rethink their profession too. We should explore beyond the narrow boundaries of what needle goes where, embrace wider ideas and incorporate new discoveries to truly realise the spirit of what the Yellow Emperor wanted to convey.
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