Chasing the Dragon's Tail

Yoshio Manaka, MD with Kazuko Itaya and Stephen Birch ·

'

CHASING THE DRAGON'S TAIL THE THEORY AND PRACTICE OF ACUPUNCTURE IN THE WORK OF YOSHIO MANAKA

Yoshio Manaka Kazuko Itaya Stephen Birch

PARADIGM PUBLICATIONS

BROOKLINE, MASSSACHUSETTS

1995 /

Chasing the Dragon's Tail The Theory and Practice of Acupuncture in the Work of Yoshio Manaka Yoshio Manaka, Kazuko Itaya, Stephen Birch © 1995, 2008 Paradigm Publications ISBN 10: 0-912111-32-1 ISBN 13: 978-0-912111-32-2

Library of Congress Number: 95-10827 All rights reserved. Under penalty of law, no part of this publication may be reproduced, stored in a retreival system, or transmitted in any form by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Printed in the U.S.A. Paradigm Publications www.paradigm-pubs.com Distributed by Redwing Book Company 202 Bendix St Taos, NM 887571 www.redwingbooks.com

Cover illustration and chapter headings by Yoshio Manaka Cover design by jack Boyce Illustrations and Drawings by Herb Rich III

Fourth Printing 2008

TABLE OF CONTENTS DEDICATION

iii

PREFACE

v

ACKNOWLEDGEMENTS

viii ix

INTRODUCTION GLOSSARY OF TERMINOLOGY

xxix xxxvii

DESIGNATION SECTION

1: SIGHTING THE DRAGON

CHAPTER 1: ACUPUNCTURE; TRADITION

1 & TRANSMISSION

CHAPTER 2: THE X-SIGNAL SYSTEM

SECTION

3 17

2: IN PURSUIT OF THE DRAGON:

RESEARCHING AND EXAMINING TRADITIONAL THEORIES

3: YIN-YANG THEORY CHAPTER 4: THE CHANNEL SYSTEM: f!NGLUO CHAPTER

39

CHAPTER 5: THE 8 EXTRAORDINARY VESSELS AND THE OcTAHEDRAL MODEL

41 49 81

CHAPTER 6: THE FIVE PHASES

87

THEORY

SECTION 3: REACHING FOR THE TAIL: TRADITIONAL CONCEPTS IN PRACTICE: REGULATING THE SIGNAL SYSTEM CHAPTER 7: SYNTHESIZING DIAGNOSIS & TREATMENT

109 111

CHAPTER 8: DIAGNOSTIC ASSESSMENT

127

CHAPTER 9: CLINICAL TREATMENT: STEP ONE

155 183 205 245

CHAPTER 10: CLINICAL TREATMENT: STEPS TWO AND THREE CHAPTER 11: SYMPTOM CONTROL TREATMENT: STEP FOUR CHAPTER 12: HOME THERAPIES: STEP FIVE

SECTION 4: RIDING THE DRAGON: CASE STUDIES FROM CLINICAL PRACTICE CHAPTER 13: CASE STUDIES FOR STEPS ONE AND TWO CHAPTER 14: ILLUSTRATIVE CASE STUDIES FOR TOTAL TREATMENT

263 265 285

APPENDICES APPENDIX 1: PRESSURE PAIN: PATTERNS, INTERPRETATIONS, ORIGINS APPENDIX 2: SELECTED RESEARCH PAPERS OF MANAKA AND ITAYA APPENDIX 3: YI f!NG SYMBOLS AND SIGNALS IN ACUPUNCTURE APPENDIX 4: ON THE SAYOSHI AGENT APPENDIX 5: A MATHEMATICAL MODEL FOR THE FIVE PHASES APPENDIX 6: FURTHER THOUGHTS ABOUT THE NATURE OF THE X-SIGNALS

311 327 363 375 391 413

BIOGRAPHY OF YOSHIO MANAKA

425

BIBLIOGRAPHY

421

INDEX

429

/

DEDICATION Dr.Yoshio Manaka died November 20th, 1989. Many mourned the loss of a gentleman and a genius, a true Renaissance man. The manuscript for this text had been approved in all but its printed form by that date. It has been particularly difficult for those of us working on this book to break our tangible connection with the master and get the book to press. Finally we have been able to make this transition. We hope that our efforts have been worthwhile and we apologize for the delays.

Shu Ha R i

PREFACE

As a young man preparing for medical school, I was absolutely convinced that everything my science teachers taught was "true." I had no doubts; the world was secure and comfortable. Studying medicine was to be the extension and application of all that I had learned, and was expected to learn; the body's "ultimate truths" would soon be revealed to me. I began preparing in advance and bought a large medical textbook. I read this book with great excitement, from cover to cover. There were descriptions of the increasingly complex inner world of the body, biochemistry and biophysics applied in a seemingly endless manner. But why this doubt, these nagging unanswered questions, a sense of disappointment? Where were those truths I knew existed, but had not yet studied? Was it possible that medicine had overlooked something? Memory of an earlier experience was flooding my mind. I recalled my arrival at the age of eight at English boarding school. Departure from home and familiarity had left me emotionally unsettled for a period of time. I had spent the first several years coming down with one malady after another, and was constantly in and out of the sick room. One day, when returning from such an episode to confront two weeks of study to be done in one, I had decided that enough was enough. It was another five years before I even caught a cold! Because of this experience I knew with absolute certainty that I had decided when I would get sick, when those bronchial and upper respiratory infections would set in. It was not a purely biochemical event. This was experiential knowledge that none could deny. Yet, years later as I read the medical text, I discovered that medicine seemed to know nothing about this phenomenon. I was distressed. I had expected that an increase in the complexity and detail of what I studied would explain my own experience. But, it was completely absent! Was this experience true only for me or was it a more general truth? Could many (or possibly all) diseases come from mental and emotional distress? I did not know. But I did know that medicine's picture of the world neither asked nor answered my question. For me, this was an unacceptable flaw. This and other questions lead me to study philosophy instead of medicine. What better place could one turn to find answers? I could not have been further from the truth. I did learn the great thinkers and the assumptions that had spawned the modem world, its science and medicine. I did learn the reason for the unwillingness or inability of medical science to tackle my question. But I came no closer to answering the question myself. In all its wondrous complexity, philosophy came no closer to explaining the reality of my experience. And, if a theory were incapable of explaining the most elementary of things - one's own experience - what use was the theory?

/

vi

Preface

In hindsight, it is easy to explain these conflicts. I wanted truth and found only contradiction and assumption. The more I studied, the ~ore complex the questions became. Truth was not, after all, out there for the takmg. It was. an elusive, slippery devil. These conflicts and questions steered me towards Ind1an and Chinese thought, where I found more acceptable truths, that is, truths that served my need. I discovered that everything was relative. My appreciation of these simplistic yet adaptable metaphysical descriptions finally led me to study acupu~c­ ture. Here, I hoped, I would learn not just another truth, but how to do somethmg with the truths I knew. I could help people improve the quality of their lives. I soon learned that acupuncture was not a truth. Instead, I found a host of seemingly contradictory systems that came laden with perspectives, viewpoints and different assumptions, all of which seemed to have some clinical validity. I also found that there was a price to pay for this knowledge. All the science that I had studied seemed irrelevant and cumbersome. These systems were no more accepting of science than science was of mental and emotional factors. Truth again proved elusive and exclusionary. At first this was acceptable; I was gaining knowledge about a phenomenon I had experienced, and I was learning how to use this knowledge to good purpose. But, as my studies broadened my earlier questions resurfaced in new guises. Surely there must be someone addressing these issues and conflicts? Elusiveness made the problem interesting, but contradiction and exclusivity were unacceptable. Wasn't there a middle ground, some way of reconciling different truths? It was in this context that I first encountered the work of Dr. Yoshio Manaka of Japan. My introduction to his work came in 1982 while working on a variety of book projects as a teaching assistant. I was intrigued and delighted by his ideas and his gentle and effective treatments. As I continued to work, I was gradually introduced to more of his ideas, research, and theoretical descriptions of acupuncture. I was once again confused. It was satisfying to find someone who was attempting to bridge science and acupuncture, but he was using terms - topology, isophasality, octahedrality- that were unfamiliar. It was not easy to grasp how these concepts related to acupuncture. His ideas seemed vast and sophisticated, but adrift.

By the time of Dr. Manaka's 1985 seminar in San Francisco, I was beginning to piece parts of his model together, but still it seemed like shimmering moonlight on a heaving ocean. When he invited me to study with him at his hospital in Odawara, Japan, I was very honored. I was to help with the writing of this book, so my studies intensified and my reading was directed to new areas as I tried to keep pace with his teaching. I was not prepared for the intellectual shock, the breadth and depth of his work and practice. This was more than just the shock of losing a naive expectation, an experience that was hardly new. I had met a sensitive and brilliant giant, the equal of whom I had never known before. I was a minor composer confronting the genius of Mozart, a petty magician in the company of a real wizard. I watched Dr. Manaka transform the so-called "pseudoscientific speculations" of an obscure, traditional medical theory into a rational scientific model. His unusual experiments and models suddenly became clear for the first time. I could see the importance of his work. Here were the foundations of a new model that was capable of explaining and exploring both traditional and modem theories without trivializing either. Here, the elusive nature of truth was assumed, not hidden by the parochial exclusivity that dominated so many others. Dogma was transformed to inclusivity and freedom of thought.

Preface

vii

Neither was this a merely theoretical edifice. Almost every aspect of the model he proposed was based on clinical tests, observations, and years of successful clinical practice, not merely his own, but that of a network of skillful and dedicated workers many of whom were honored experts. Dr. Manaka's co-worker, Dr. Kazuko Itaya, had taken these seeds and germinated her own original research and undertaken years of dedicated research. In more than twenty years of work evidence after evidence had been compiled. I knew that their work was significant; in it lay answers to my questions. I came to this work forewarned. I knew of my disposition to search for truth; I was aware of my rational and irrational inclinations. I understood the phased acquisition of knowledge. We move from one stone to another as we cross the river of ignorance. But the work of Manaka and Itaya is more than just a stone in the river. It is a significant island over which we cannot see, and the distance to its furthest bank is as yet unkown. I believe the importance of their achievements is multi-levelled, requiring careful examination. It is here that my work begins. It is a great honor for me to work on this book. I hope that my journey of discovery and daily clinical use of their ideas has made me capable of the task and that my efforts will achieve at least two major goals: - First, I hope that I can clearly and systematically organize and make accessible their theoretical, experimental, and clinical materials. As we will see, this systematization is both a necessity and a travesty. I hope I have erred on the side of necessity. - Second, in the introduction, I would like to delineate some of the important levels of Manaka and Itaya's work. There are crucial philosophical, methodological, and clinical issues that are ignored by most authors and researchers of acupuncture. I believe that these are addressed by the work of Manaka and Itaya. It is here that I would like to begin my examination and expressing my respect for the junzi, :ft =f , for his ineffable kindness, wisdom, and wit. In the garden of his home in Odawara, Dr. Manaka had a bust which he sculpted of the famous English philospher, Bertrand Russell. In recognition of his admiration for Russell, I offer a parallel between their work with this short quote from Russell's later life: I am in no degree ashamed of having changed my opinions. What physicist who was active in 1900 would dream of boasting that his opinions had not changed?

Dr. Manaka's ideas have evolved continually. At the pinnacle of his life, his ideas reached a level of refinement that could only come after many years of practice, research and study. It is only natural that ideas which seemed advanced in the past, seem a little unrefined or unfinished today. This is a struggle that many experience with their work. I see it as the mark of a true creative genius. There are more things in heaven and earth, Horatio, than is dreamt of in your philosophy. - William Shakespeare, Hamlet I:v, p. 166.

STEPHEN BIRCH

ACKNOWLEDGEMENTS

I feel extremely fortunate to have been able to study with Dr. Yoshio Manaka. It is not often that one meets a teacher who is truly gifted, talented, and generous. I cannot thank Dr. Manaka enough for his great kindness, for extending his hospitality and educating me at his hospital in Odawara in the summers of 1986 and 1988. Nor can I thank him sufficiently for his enthusiasm, his warm support, and his continued generosity. I can only hope that my efforts in this work have gone some way towards expressing my gratitude. I am profoundly grateful to his associate, Dr. Kazuko Itaya, for her generosity, kindness, and support. Their work is truly inspiring, and I hope it will now reach a wider audience. My thanks must go to many others in Japan. In particular, Dr. Junya Manaka and his wife Setsuko Manaka were very kind and helpful. The whole staff of the Manaka Hospital also showed great consideration and patience with my bumbling ways. Dr. Manaka's assistants, Morii-san, Okusada-san, Komiya-san, and Takumisan, were extremely thoughtful and generous of their time; in particular Hiromasa Okusada-san. The two of us spent most of my evenings in Japan in 1986, as well as several months here in Boston, in 1987, working together, translating, sharing ideas, brainstorming. Without his support and his contributions, I probably could not have completed my work on this book. I think he will go far in the field. Last, but not least, I must thank my family and friends for supporting and helping me. In particular, my wife Junko, for her invaluable assistance with translation, and for her constant understanding and support. I thank my father, who helped me with research particulars and made important contributions; my mother, sisters, and brother for their nurturing and patience. Thanks go to Bob Felt and Martha Fielding for their unswerving support and friendship; to Nigel Wiseman, Marty Feldman, and Mark Friedman for their suggestions; and to my patients for teaching me about health and healing.

STEPHEN BIRCH

~~

~

INTRODUCTION To fully understand the work of Yoshio Manaka, it is important to place it in its wider context. If we examine the diversity of approaches and theories in acupuncture, and the paradigmatic issues confronting the field, we can see clearly that Manaka's research arose from knowing that for acupuncture to be accepted in the West it would be necessary to explain the diversity of the field while simultaneously bridging the traditional East Asian and Western scientific paradigms. It is here that Manaka was uniquely qualified to make significant contributions.

THE CURRENT ''CRISIS" In the late twentieth century, acupuncture and East Asian or Oriental traditional medicine - herbal medicine - have sewn many new seeds and germinated many young shoots around the world. This has occurred both because of the impact of Western science and culture on the East and the reciprocal impact of Eastern culture and science on the West. There has been transmission and communication. In Eastern traditional medicines there have always been many different schools of thought. Now, there are a great many more, both from the global migration from these centers and from the influx of Western science, methodology, and medicine. Everywhere that acupuncture and East Asian medicine have traveled, some form of intermarriage has occurred. New theoretical constructs, new lines of research, new emphases grow; new methods of measurement, new methods of diagnosis and treatment spring forth. In contrast, and partially in response to this heterogeneity, attempts to preserve "original truths" also have been put forward. Many traditionalist schools have arisen, each of which carries its own banner, each of which quotes the classics to justify an often singular point of view. There is perhaps more research and debate in the fields of acupuncture and East Asian medicine today than during any other time in history. We can divide these new traditions roughly into three general categories or approaches. In the first, only the traditional language of the medicines is permitted. Everything is defined within that language. Little or no attempt is made to use or incorporate scientific or medical language and concepts. These traditions attempt to retain the original integrity of the medicine. In my earliest work with Kiiko Matsumoto, I adhered to this approach, assisting in the presentation of previously untranslated traditional ideas [FE, EV]l Other examples of this approach include the keiraku chiryo, or "channel treatment" school that began more than

x

Introduction

fifty years ago in Japan, and is now slowly emerging in the U.S. and Europe. Another, the "Traditional Acupuncture" school, was first articulated in England during the 1960's and then spread to the U.S. in the 1970's. Perhaps the most widespread example can be found in the approach of the "Traditional Chinese Medicine" (TCM) advocates who follow the ba gang bian zheng school which gained popularity in China during the 1960's and spread to the U.S. and Europe in the 1970's and 1980's. The historical developments of this system are quite interesting. The ba gang bian zheng first surfaced in the early 1700's in a little known herbal treatise, gradually gaining popularity in the field of herbal medicine. It was incorporated into the theoretical and diagnostic language of Chinese acupuncture in the 1960's, during the turmoil of the early Mao years. Though the system itself used only the language of traditional medicine, a concerted effort was made to present it in a scientific and terminological framework that was acceptable to Western medical standards. The language of the system remains technically that of traditional medicine, i.e., the terms used are traditional terms (yin, yang, qi). Thus it is classified according to the definitions above as a "traditional approach." However, because its creators actually intended it as a kind of scientific approach, it could arguably be classed in the third approach described below, the "integrationist approach."2 These schools of thought select from, and adhere conservatively to, variations of the traditional theories described in the early Chinese medical classics. Qi, yinyang, five phase, channel and zang-fu theories, are the essential premises of the medicine. They are derived from ancient texts that provide an inspirational validity, confirmed by more than two thousand years of clinical practice. These, I label "traditional approaches." In the second approach, anything not scientifically measurable (or already measured), or anything couched in non-scientific language, relying on concepts such as qi or channels, is dismissed as pseudoscience, or worse, metaphysics and superstition. For the proponents of this approach, the only valid models of acupuncture and East Asian medicine are those based in scientific study and observation that strictly adhere to scientific methodology. This approach is characterized by the dismissal or trivialization of concepts that do not easily relate to modem ideas. For example, these systems often dismiss all acupoints that do not correlate with known neuroanatomical structures, or which cannot be related to trigger or motor points that are already scientifically validated.3 This approach demands the dismissal of traditional methods of diagnosis and patient assessment, such as radial pulse palpation, considered irreconcilable with modern Western medical practice [ATP, 29]. I label these the "scientific" approaches. Their proponents, including Mann, Baldry, and Ulett, consider "scientific truths" to be determined only by the strict methodology that is the single acceptable justification of medicine. This conceptual school has gathered adherents parallel with the growth of the practice of acupuncture in the West, finding favor among those who are unwilling to dismiss the clinical evidence that acupuncture "does something," but who cannot accept a rationale based on traditional concepts and measurements. Importantly, and to an extent rarely discussed, this hard science approach actually accounts for a considerable body of Chinese work and is in practice often found in works favored by the TCM school of thought.4 While the traditional concepts are maintained, they are often defined in reductionistic terms. The Chinese, for example, frequently label such things as qi, jing, shen, etc., under the rubric "fundamental substances" in a quasi-scientific manner.s

Introduction

xi

A third approach tries to find correlations of acupuncture and East Asian medical models with Western medical systems, explaining the terms and concepts of each in the language of the other. This is the "integrationist" approach. It attempts to avoid rejection of the models and concepts of either system, seeking instead to create a delicate symmetry between them. A good example of this approach is Yves Requena's Terrains and Pathology in Acupuncture. Dr. Requena's broad and brilliant attempt to explain concepts from traditional literature in the clinical and theoretical terms of Western biomedicine is perhaps the most sophisticated of the integrationist approaches. Often the analysis and technology adopted by these approaches discovers information and correlations not described in the traditional literature. This has led to the development of adapted versions or new syntheses. Good examples of this can be seen in the work of Dr. Voll in Germany, and from Japan, in the work of Dr. Nakatani.6 Both these methods base their starting point on findings that the channels and their acupoints are measurable electrically. From this common base, each group has evolved unique equipment, techniques and theories. Each of these three general approaches to acupuncture and East Asian medi- . cine is important. These categorizations are not inclusive of all styles of acupuncture. There are a series of new non-traditional therapies that fit none of these categories. The auriculotherapy of Dr. Nogier from France and the Koryo Sooji Chim hand acupuncture of Tae Woo Yoo from Korea are each modem systems that cross the boundaries of these general categories. As an overall schematization, however, these three categories define the various guidelines for acceptance of the truths of the medicine. Within and between each of these three categories there is much discussion, debate, and conflict. In large part this serves to exhaust the resources and distract the proponents of each system from issues that remain unaddressed. Yet the existence of disagreement is integral to attaining medical and scientific growth. These three approaches are necessary as part of a developmental process. Unfortunately, the axiomatic truths of each system are defined so as to exclude the truths of any other system. This is particularly obvious between the first and second approaches, where the various traditional and scientific practitioners find little basis for agreement. While less obvious in the third approach, the exclusivity built into both Eastern and Western paradigms allows hidden contradictions to remain unchallenged. Problems are posed at many levels, one of which is terminology. For instance, in the Western practice of acupuncture and East Asian medicine, the term gan .Iff means something a little different depending on who uses the term. It denotes a rough correspondence to the Western term, "liver." The Eastern usage of gan refers to something different than the liver, although it may include that organ, or some anatomical and functional component. Consequently, the use of terms is confusing and contradictory between different schools of thought. The problem is worse with the most common terms of acupuncture and East Asian medicine, such as qi ._ or jing luo ft. , which have no historical counterpart in the West or epistemological parallel in science. There are not even equivalent terms that can be used. Sinologists, translators, and scientists have struggled with this problem for years. While some headway may have been made,7 only the surface has been scratched. Underlying paradigmatic questions remain unaddressed. A further and related problem is that of social acceptance. For all we know, acupuncture and East Asian medicine may actually work better in the East than in the West because its basic concepts are already familiar. Further, the sociological

xii

Introduction

process of disease and healing that is regarded by some as important in health and disease already impacts medical systems in their native countries. Hidden expectations and psychological attitudes can, of course, play a significant role in the healing process. Again, progress has been made, but even this investigation has only just begun [FCM, xvii-xxxvii]. However, these too are essentially surface issues; the most critical differences lie at the level of the Eastern and Western knowledge paradigms. In his Introduction to Fundamentals of Chinese Medicine, Ted Kaptchuk begins to define this question, though he leaves it largely unanswered. He argues for the integration of Western psychological and psychosomatic concepts into the acupuncture and East Asian medical models so that practitioners may address the greater emphasis on those issues in the West. While it is greatly to Kaptchuk's credit that he has recognized and framed the issues, questions of emphasis in the somatic and psychological origins of disease are at root philosophical and not sociological. Until the underlying assumptions are examined and explored, the anthropological and sociological issues remain isolated and unresolvable [FCM, xviixxxvii]. The assumptions which support social, mental, and linguistic differences are more significant. The conflict at this level gives rise to many of the surface conflicts, like a submerged leviathan that disturbs the surface of the sea. If we are to make any headway in resolving these problems, we need to recognize that conflicts are only useful when they engender negotiation, mutual acceptance, and a recognition of the need to strive for compromise. Refusal to examine these issues cannot change the mutually exclusive standoff where the various schools of thought are mired. Compromise has been sought in several avenues, none of which have resolved fundamental differences. The integrationist approach has evolved technical means for finding common ground and constructing a model that is at least partially acceptable to both views. For sinologists and translators, the solution has required avoiding the established terminology of any and all the schools so that methods capable of distinguishing the subtle nuances of both the English and East Asian languages could develop apart from the charged atmosphere of loyalty to approach. For medical anthropologists, proffered solutions outline methods of adapting medical systems so that they may recognize social and attitudinal differences. These are all admirable approaches, representing honest and necessary attempts to solve existing problems. Without the lessons of parallel and similarity in the works of authors such as George Soulie de Morant and Yves Requena, the field's source of study and imagination is impoverished. Without the linguistic precision of a translator such as Wiseman,B we are afloat on a sea of unspoken assumptions where both similarities and differences are lost to examination. Without the anthropological insights and precise methods of an Unschuld,9 we have no means of study or comparison. But, for the traditional and scientific practitioners, these approaches cannot reconcile their differences. These two groups logically exclude one another. Without a paradigmatic solution, the translational and anthropological attempts of the integrationist approaches must ultimately fail to direct the course of acculturation. The compromise which we seek must do much more. It must address issues and resolve conflicts at the most fundamental level. World views, the fundamental assumptions and axioms of knowledge itself, must be examined. If we construct a broader paradigmatic model and develop a language capable of embracing the

Introduction

xiii

opposing viewpoints, we are then able to resolve conflicts and aid in the mutual acceptance of Eastern and Western medicine. As we shall see in Manaka's work, the theories of acupuncture and East Asian medicine stand on the same theoretical ground with Western science. Apparent conflicts exist because we ignore or refuse to acknowledge twentieth century science itself, which has moved beyond the older Newtonian sciences that dominate medicine and biology. Modem Western science shares premises with acupuncture and East Asian medicine. This has been noted before [TaoP], but as yet has been given little attention in science, acupuncture, or East Asian medicine. The parallels and similarities are so strong that they can not be ignored. Western science, Western methodology, and their offspring, Western medicine, require a reinvestigation of their own roots in the nineteenth century. So too must acupuncture and East Asian medicine reexamine their roots in earlier eras. The traditional schools of thought that depend on ancient classics, and the scientific schools of thought whose rationale are inextricably tied to the assumptions of an earlier science, share this responsibility. Because we must meet issues that cross the boundaries of these disciplines, everything should be investigated. If similarities can give us a common language, we will possess a powerful tool for resolving both intertraditional and interdisciplinary conflicts. However, let us remember, as Max Planck admirably stated: A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows that is familiar with it [SMR, ix-x].

The current political realities and power struggles may not surrender to a common solution, but they will simply fade as the confluences of personal, financial, and intellectual interests age and are replaced. Nor will the development of an embracing philosophical model magically resolve all conflicts. Yet the synthesis and development of a new language and model, such as those Manaka offers in the pages of this book, may well serve as a lighthouse to guide us away from the rocks of exclusionary dissent, assured mutual discontent, and probable destruction. It can protect us from unacceptable alterations of the medical system, what Kaptchuk aptly termed "a mutant based on fantasy" [FCM, xxxvi].

PARADIGMATIC WORLD VIEW ASSUMPTIONS With the exception of politically influenced modern Chinese works on acupuncture and East Asian medicine, both practitioners and scholars agree that these medical systems are founded on a non-reductionist paradigm [SCC, 2:556]. All things in the world interact with all other things in varying degrees. This is typically, and most generally expressed, by the following schema: heaven I person I earth This image of the most basic levels of interaction is found in the Yi Jing, in many early philosophical and scientific texts, and throughout the medical literature. Human existence (and in fact all forms of life) are the result of the interaction of heaven and earth, relative symbols referring to general cosmic organizing principles or forces. Inherent in this world view is the idea that one cannot really describe separate objects. Everything exists in a web of relations. They are thus nonreducible. Almost all the early medical texts take these ideas as first premises. Joseph Needham has written a beautiful characterization of these interrelationships:

xiv

Introduction

Things behaved in pa:ticular ways not n~cessa:i.ly ~ecause of prior. actions. or impulsions of other thmgs, but because thetr posttwn m the ever-movmg cycltcal universe was such that they were endowed with intrinsic natures which made that behaviour inevitable for them. If they did not behave in those particular ways they would lose their relational positions in the whole (which made them wh~t they are), and turn into something other than themselves. They were thus parts m existential dependence upon the whole world-organism. And they reacted upon one another not so much by mechanical impulsion or causation as by a kind of mysterious resonance [SCC 2, 281].

Reductionism, on the other hand, is the mainstay of modern Western biology, chemistry, and medicine [SMR, 29p]. All things are seen as reducible to their separate parts (atoms, molecules, cells, etc.). The study of these parts allow us to describe the thing studied by combining the properties of the separate parts: The basic tactic of natural science is analysis: fragment a phenomenon into its components, analyze each part and process in isolation and thereby derive an understanding of the subject. In physics, chemistry, even biology, this tactic has worked splendidly [SMR, 62].

Today both scientists and philosophers take ontological reduction for granted. Vitalism is dead. Organisms are "nothing but" atoms, and that is that. [SMR, 51].

It is also clear that the Eastern theories are non-dualistic in nature. No clear distinction between mind and body and no separation of mind and body exists.lO This is generally held to be true, although there are examples in the traditional literature where the reverse opinion is also held. This has led one author, in a thorough analysis of the issue, to conclude:

What we have found is that this heterogeneous collection of early Chinese medical writings reflects many still-evolving, ambiguous, even conflicting views on this subject. Much of the evidence is in line with the basic perspective of a unified body and mind; yet, not to be denied or overlooked, other important evidence reveals that conceptions of the mind are at points definitely distinguishable, if not sharply divided, from conceptions of the body. In other words, high-level generalizations made in the past about Chinese approaches to the mind-body problem are basically correct; but they do not go far enough.ll

While thus not altogether "correct," this view of the non-dualist nature of acupuncture and East Asian medicine must be accounted for in a treatment of the subject, all the more so since most of the literature supports this view. Discussions in the medical literature clearly reflect this non-dualistic attitude. It is typically said, for example, that anger will "injure" the gan (liver),12 yet if the gan develops a problem, anger and irritability may result [ECA, 68; FCM, 236; EV, 256]. In modern medicine and biology, dualism is prevalent. Ever since Descartes' famous "cogito ergo sum" ("I think therefore I am,"), the mind and body have been studied and treated as separable and separate entities. The body is viewed as a machine that can function independently of the mind [SMR, 24]. In the West this has presented a considerable difficulty to medicine [SMR; TSM, 59p ], whereas in acupuncture and East Asian medicine, Humpty Dumpty never fell from the wall and no effort was required to put him back together again. No clear separation of mind and body was made, thus there was no need to reassemble the parts [HD]. It is significant that in the modern Western literature on acupuncture and East Asian medicine, there is little reference to the non-dualistic nature of Chinese thought.l3

Introduction

xv

A third distinct difference between East Asian philosophical views and ~estern philosophical views is thatof causality versus acausality. Western science

1s based on a cause-effect model where all things--fullow-adirect causal logic. A moving object striking a stationary object will cause that object to move in a particular direction, with a particular velocity, that is directly calculable from the velocity and angle of collision, and the masses of both objects. The presence of streptococcal bacteria will cause a streptococcal infection. Disease is seen as a disorder of mechanisms [STM, 14], and mechanisms are pure cause and effect models. While it is recognized that the cause and effect model of disease is becoming unmanageably complex [STM, 60], causality is still assumed even where it cannot be empirically demonstrated. Yet acupuncture and East Asian medicine are, for the most part, acausal. Causality for the Chinese was quite different. It was, as Needham states, based on a philosophy of organism: Nothing was un-caused, but nothing was caused mechanically. The organic system in the prompter's book governed the whole. And the characters in the eternal dramatic cycle were, as has been said, in existential dependence upon the totality of the system. [SCC 2, 283].

There are the Yin and the Yang. All things have their chi-kang [fixed positions and motions with regard to other things in the web of nature's relationships]. The sun, moon and stars signify punishment or virtue, and their changes indicate fortune and misfortune. Metal, wood, water, fire and earth conquer each other successively, the moon waxes and wanes alternately. Yet these normal (changes) have no ruler or governor.If you follow it [Heaven's way] virtue will be attained, if you violate it there will be misfortune. [SCC 2, 255].

These quotes state succinctly what I have termed the acausal model of acupuncture and East Asian medicine, when seen in distinction to Western science's causality model. It is the network of relationships that provides an indeterminate result. If one is able to follow the rules of this network, the dao (tao), one will remain virtuous and healthy. Conversely, not following the rules will lead to poor health and disease [SW, ch 1,2p]. Multiple factors taken together are seen as causing disease. This is not cause and effect in the normal sense; rather it is the interaction of a multiplicity of phenomena, which under the right circumstances will lead to disease. Stomach pain develops as a result of an increased caffeine intake irritating a patient's already complex condition, where factors such as poor diet, alcohol consumption, cigarette smoking, menstrual difficulties, tight musculature, poor exercise habits, home and work stress, each contribute. In a recent lecture, Paul Unschuld drew attention to the fact that traditional Chinese medical theories are rife with reductionist and causal theories and references, what he has identified as the "ontological" approach, while we in the West have as yet only really focused on and selected from the holistic or "functional" aspects.14 It is true that not all the theories of acupuncture and East Asian medicine fall within the category of this synthetic or holistic approach to health and disease, yet many of the important theories do, specifically those of yin and yang and the five phases, which are particularly important in acupuncture. Thus a valid approach to acupuncture and East Asian medicine must address both levels, but first we must at least solve the not inconsiderable problems associated with understanding the "functional" approach, which is essentially non-reductionist, acausal, and non-dualist. The "ontological" approach mostly seems to occur in reference to the origins and causes of disease, while the "functional" approach refers to and

xvi

Introduction

describes the healthy dynamic systems. In this regard, the principal difficulty for the traditional, the scientific, and the integrationist approaches to acupuncture resides in the following question: - How can we describe the non-dualist, non-reductionist and acausal medical systems of acupuncture and East Asian medicine in the dualist, reductionist, and causal language of the West, especially Western science and medicine? Indeed, can we make such a description?15 Clearly, this is a problem for the scientific and the traditional approaches, but it is particularly problematic for integrationist approaches where a reciprocity of description is taken for granted. With their backs to the wall, the proponents of the scientific approaches can always argue that there remains a logical possibility that one day all the mechanisms of acupuncture and East Asian medicine will surrender their secrets to scientific methods [SMR, 138p]. But, as we will see, this too runs into difficulty. With the advent of subatomic physics, relativity, and quantum theories, twentieth century science overturned the basic assumptions of a dualist, reductionist, and causal world that are implicit to modem medicine and the scientific approaches to acupuncture and East Asian medicine. Thus, the question applies for not only their approach to Eastern ideas, but to all Western science itself. As a consequence, serious methodological questions arise. The problems for the traditional approach are many-leveled. There are obvious scholarly and anthropological difficulties that must be addressed. As soon as we translate acupuncture and East Asian medical literatures into our language, as soon as we import these medicines with all their cultural underpinnings into another culture, we meet this problem. The language and concepts we use in these transitions contain implicitly all the paradigmatic assumptions of the new culture. In the U.S. and Europe, these are essentially dualist, reductionist, and causal. Thus in the Traditional Acupuncture schools of Britain and the U.S., an emphasis on the "psychospiritual" components of disease has developed. This does not accurately reflect the original acupuncture literature, because the distinction made could not have existed. The two terms, psychological and spiritual, cannot be made whole as easily as they are combined to make the single term "psychospiritual." This raises the question as to whether this particular school of thought should be considered an integrationist adaptation rather than a traditional, conservative movement. In a further confusion of conceptual terms, the school places great emphasis on the diagnosis of a "causative factor" (CF), the single underlying cause of disease. It is clear that this school must attend to at least the dualist- non-dualist, causal- acausal dualities in its rationale. In the traditional Chinese medicine (TCM) approach, the Chinese Marxist reliance on empirical findings (i.e., what works), sacrifices methodology and theory. The logical view of TCM in the West lies somewhere between the non-reductionist, non-dualist, and acausal logic of the traditional literatures and the reductionist, dualist, causal logic of Western biomedicine. Much of the traditional literature is ignored as it cannot be made to fit the mold of empirical theories [FCM, xxxii-xxxv; MCHI, 229p]. This is epitomized in the following statement, which presents an inherently unacceptable position: Retaining only the theories that have practical value will do no damage to the theoretical body of Chinese medicine. Indeed, it will help eliminate the constraints, develop it further, and raise it to the standard of a modern medicine. [FCM, 18].

Introduction

xvii

This ignores correct scientific methodology to such an obvious extent that such statements are more often than not deleted by Western translators whose views permit such expurgations. The assumption that the clinical techniques utilized in China today have no bearing on the outcome of clinical studies of systems and ideas outside of the current Chinese model is simply and prototypically bad study design. Applications of particular techniques are rooted in the theories that produce them. It is poor inquiry to use those techniques for investigation of the practical value of other systems and theories. These assumptions do not allow accurate judgments about the practical value of a particular theory. To think that no damage is done to the theoretical body of Chinese medicine is naive at best. By attempting to modernize and Westernize its presentation, traditional Chinese medicine has created a conceptual void. Without an acceptable methodology, it cannot be acceptably Western. Using materialist and Marxist logic, it cannot be traditionally Eastem.16 Traditional systems must be able to explain themselves to the modem (and Western) world. Logically, it is not acceptable to subsume ideas from both paradigms, thereby attempting to create a new vision of the medicine, without addressing their fundamental contradictions. Nor is it logically acceptable to ignore these fundamental questions by focusing instead on a plethora of clinical results. The issue is not that acupuncture and East Asian medicine observably work (although this too is an important question, sorely in need of appropriate resources and rigorous studies); it is rather, what consistent logical description can we make of what we observe? A system which addresses and answers this paradigmatic conceptual question stands on firmer ground. If it is possible to generate a larger world view that sacrifices neither the conceptual integrity and ingenuity of the traditional theories nor the conceptual richness of modem science, we will have a model capable of carrying acupuncture and East Asian medicine successfully and globally into the twenty-first century. Indeed, if this model is to be successful, it must mutually embrace both paradigmatic systems [SSR]. Before examining and detailing such a model, one already in parallel development for Western medicine, it is important to discuss those developments in the physical sciences that demand the revolution in biological and medical thought. If we ignore these developments, we will miss the most promising solutions to our problems, and be consigned by the future to "the museum of medical oddities." If anything is clear, it is that all the social, political, or intellectual schools of thought now used to define acupuncture and East Asian medicine will be unable to meet this challenge.

THE WESTERN PARADIGMATIC DISSOLUTION

Since the major developments of twentieth century theoretical and experimental physics are known through many technical and popular works, little needs to be said here. It will be sufficient to look at conclusions relevant to our discussions, with regard to the paradigmatic world view. These developments are not the only developments of this century that have radically challenged the old paradigm. Troubling discoveries in the study of chaotic and thermodynamic systems, especially mathematical models of these, are also bearing the layman's paradigm to its grave. Besides these changes in scientific speculation, equally important changes in inquiry methodology have occurred. It is now clear that not only have the reductionist, dualist, and causal assumptions of the old paradigm been called into question, but that non-reductionist, non-dualist, and acausal methods must be used. There is simply no other option. At the leading edge of many fields of inquiry,

xviii

Introduction

such systems are developing, with the outcome that rich vocabularies and models with which to examine acupuncture and East Asian medicine are now available. With Einstein's original formulations of the theory of relativity and the development of quantum mechanics, the notion of a world reducible to its separate components came under fire. In physics, at least, this concept met its end, but in the life sciences, biology and medicine, for example, it still prevails. Foss and Rothenberg, Dossey, Capra, and others argue for the need to update the life sciences so that they come into line with these developments. Probably the clearest and strongest theoretical and experimentally validated expression of the non-reducible nature of the world can be seen in Bell's theorem from the 1960's.17 Bell's theorem continues an argument begun by Einstein. He shows that it is possible for any particle in the universe that has interacted with another to afterward respond instantaneously to a change in the second particle, regardless of the distances separating them. The implications of this are enormous. At the very least, the reductionist program will no longer hold its ground. It is possible, even probable, that all things in the universe are interacting with all other things, all of the time. It is only in our imagination that they are separate: This seems to imply that in some sense all these objects constitute an indivisible whole. [STM,100]

The Cartesian conception of reality as consisting of separate parts, joined by local connections, is incompatible with quantum theory. [TurP, 83]

This theory and its experimental validation further demonstrate that the cause and effect model is incorrect.

If the statistical predictions of quantum

theory are true, an objective universe is

incompatible with the law of local causes. [STM, 98].

In relying on simple perceptions and experiments, the influences of non-local phenomena can be neither measured nor ruled out. Thus, attempts to construct simple cause-and-effect models are doomed to failure. Modern physics tells us that the world does not function in such a manner. Note, too, that it is not that we have failed to construct adequate cause-and-effect models; it is that adequate cause-and-effect models cannot be constructed. The dualist program fares no better. Bell's theorem and the Einstein-RosenPodolsky thought experiment on which it was founded also show an interdependence and interconnectedness between mind and matter. This is clearly seen in Heisenberg's famous uncertainty principle, which places limits on our observations and measurements of nature: Heisenberg stressed that the laws of nature no longer deal with elementary particles, but with our knowledge of these particles- that is with the contents of our minds. [SMR, 144].

The conclusions and implications of this are well stated by Bernard d'Espagnat: The doctrine that the world is made up of objects whose existence is independent of human consciousness turns out to be in conflict with quantum mechanics and with facts established by experiment. [SMR, 145].

Introduction

xix

Thus the old scientific paradigm is no longer correct or appropriate. The world is non-reducible, non-dualist, and acausal; theoretical physics has experimentally confirmed this. We cannot separate the human subject from the world. We are the participator in an indivisible whole, both affected by and affecting all things. We are immediately reminded of the web of nature's relationships which lies at the heart of the traditional Chinese world view. What can we learn and use from this? By what methods, and with what language should we describe the world? These remarkable developments have prompted some scientists to describe quite different models of nature. The physicist David Bohm, for example, has developed a theory in which most of what is, is not perceivable or measurable; it is hidden or enfolded in space. The perceivable and measurable world, the world that our senses detect, is like the ripples on an ocean where everything beneath this surface is hidden from us, and all parts are derived from this ocean. He describes how the activities and rules of this hidden or implicate order have great significance relative to the observable or explicate order, that which we can sense.18 In this manner he can describe many of the findings of twentieth century science. He also uses the holographic paradigm to describe this implicate order. He proposes that the universe is a hologram, wherein all parts of the whole contain images of the whole. With this model and its vocabulary, he is able to describe the world in non-reductionist, acausal, and non-dualist language. His, and related models, have proven fruitful for describing mind-body interactions, in exploring wholeness and acausal events. As we will see, this is a useful starting point for developing a model and language for acupuncture and East Asian medicine. According to the second law of thermodynamics, the entropy of a closed system increases with time. Systems eventually degenerate to a state of disorder or chaos, or so it was believed. In the last few decades, researchers from around the world and from many disciplines have been discovering that the reverse is actually true.l9 As systems degenerate to disordered or chaotic states, they spontaneously show signs of order again. This may seem insignificant or unimportant, but it represents perhaps one of the most important scientific advances of the twentieth century. Hidden within chaotic systems are very fine, complex, ordered structures. Chaos brought an astonishing message: simple deterministic models could produce what looked like random behavior. The behavior actually had an exquisite fine structure, yet any piece of it seemed undistinguishable from noise. [Cha, 79]

Chaos was the end of the reductionist program in science: Simple systems give rise to complex behavior. Complex systems give rise to simple behavior. And most important, the laws of complexity hold universally, caring not at all for the details of a system's constituent atoms. [Cha,304]

In the reductionist view, properties of a system are seen as the result of the sum of the properties of the component parts of the system. In the new paradigm, properties of the whole system, which are not dependent on the component parts of the system, and which obey universal laws, are seen as being essential to the behavior and regulation of the system: Chaos brought to life a new kind of physiology, built on the idea that mathematical tools could help scientists understand global complex systems independent of local detail. [Cha,280].

xx

Introduction

These startling findings provide a rich language and conceptual framework for modeling properties of complex whole systems. Like Bohm's theory of the hidden or implicate order, they give us words for describing hidden or enfolded orders in the body, such as those described by the medical theories of China, which are not accessible through the reductionist, dualist, and causal logic and language of the old scientific paradigm. These changes in science have necessitated a change in the way we model nature and a change in the way we inquire into nature. It is here, in the development of appropriate models and language, that we find probable solutions to the questions raised above. They allow us to describe the concepts of acupuncture and East Asian medicine in terms that are remarkably similar to the original Chinese concepts. The language may at first seem strange, and until the necessary conceptual developments are complete, these technical languages must remain.2°

EMERGING FRAMEWORKS AND MODELS Two of the most common conceptual models that have been used to describe nature, and how humans interact with nature, are General Systems Theory and Information Theory. Some authors believe that the use of these conceptual frameworks may be the only possible solution to the very complex models of nature that have sprung up in this century and which bypass the usual reductionist, dualist and causal impasse [SMR]. General systems theory proposes that we model the hierarchical nature of life as a series of systems that mutually interact. This model implicitly recognizes the non-reductionist, non-dualist, and acausal nature that has been demonstrated by twentieth century physics. Systems are integrated wholes whose properties cannot be reduced to those of smaller units. Instead of concentrating on basic building blocks or basic substances, the systems approach emphasizes basic principles of organization. [TaoP, 266].

Each person consists of innumerable systems, the various organs, tissues, cells, molecules, atoms, subatomic particles. Each person is part of a small group, a family, which is part of a larger community, which is part of a larger group. Each level or system has its own organization and associated activities, but each level acts on each other level; it is an indivisible whole. Information theory allows descriptions of complex phenomena when the mechanisms and processes are either known or unknown: "Information" is a complex concept that has been given various definitions in such fields as thermodynamics, communications and probability theory. Generally speaking, it is a measure of the order existing in a system - a certain degree of order represents information - and it implies the deliberate selection of one event out of a number of possibilities. Information is any pattern of events in time and space ... The form or structure of the body has informational content. 21 It has been noted that organisms constantly exchange energy with the environment. This is part of life's adaptive processes; however, it is the informational exchange that is more significant in this adaptive process. The energy is of course important, but change results from the information content of the energy.22 The ingestion of food, fluids, air, the reception of sense data and behavioral stimuli all represent informational input. The excretion of waste (gaseous, fluid, solid), the

Introduction

xxi

e~p.enditure ~f energy through work, behavior, all represent informational output. L1vmg orgamsms are open systems, meaning that their information is both input and output.

In the systems model, what passes back and forth between each interacting system or level is information: Living systems exhibit multi-leveled patterns of organization characterized by many intricate and nonlinear pathways along which signals of information and transaction propagate between all levels, ascending as well as descending. [TaoP, 282].

Information theory thus allows us non-dualist, non-reductionist, and acausal descriptions of nature. Information rather than causality describes processes within or between organized systems. The most general model of a natural process on which scientific explanation may be based is no longer the movement of a particle under the action of a force, but the storage (or organization) and the transmission of information within a system. [SMR, 182].

This seems to fit the criteria for an appropriate language to describe living things in the manner of modem physics. The findings of modern physics have led to the conclusions that while processes in nature may follow simple rules, the processes themselves are actually complex. Biological systems are particularly good examples of this complexity. The systems described by physics are simple systems and are the exception not the rule; complexity is almost always encountered: [This will] demand a completely new vocabulary. Crucially, for example, the quantities that change will be informational in nature. Simple systems of the type traditionally studied in physics (where states and dynamical laws in the form of differential equations constitute a highly idealized scheme) from complex systems "describable by a web of informational interactions" [CB, 159].

Ideas called "software laws" by Paul Davies (see Dr. Manaka's use of this analogy in chapter four) allow such distinctions. Living systems are just such complex systems with a "web of informational interactions." The software laws are not logically derivable from the underlying hardware laws, the physical processes; they relate to emergent phenomena and properties, i.e., they relate to non-reducible properties which arise as a product of whole body activities. The use of information and systems theories as a framework for describing these properties, and for resolving the methodological problems of Western science and medicine, is encountered in many places.23 I would not be the first to point out parallels in traditional Chinese theories and systems theory,24 but repetition of these ideas is useful, as is noting the parallels of traditional Chinese ideas to information theory [HD, 417-422]. Numerous other parallels can be drawn. Needham's characterization of the web of relations within which everything in Chinese thought is seen to exist [SCC 2, 255,556], and the web of informational interactions characterized by Davies [CB, 159], represent significant similarities, not only for their similar language, but also for their paradigmatic similarities.

xxii

Introduction

In Chinese thought the three-leveled system of heaven-person-earth is described in many places. In the application of information theory generalized to open systems, i.e., biological systems, we find strong parallels [AC, 101-104]. The living organism receives information from both the terrestrial environment and the larger (solar) environment. This information feeds back to and constrains (interacts) through each level. In the three-leveled system, the various qi of heaven, earth, and people interact. The information subsets of the larger (solar}, closer (terrestrial}, and living organism (person) interact. In this many-leveled system (described in Hara Diagnosis), qi passes back and forth between all levels, as general and specific forms of qi, described by different traditional theories according to the levels involved in the exchange. Changes at any level eventually filter down through all levels. In the multi-leveled systems described in the modem scientific literature, information passes back and forth between each level. A change in any one level effects a change throughout all levels. As well as parallels in structure and language, we can see possible parallels in content. The term "qi" is used in the traditional literature in a manner that is in many respects identical to the use of the term "information." In the traditional literatures, the term qi is used to refer to both the body in its physiological stuff, and in its processes and derived properties; that is, in a quantitative-qualitative manner, and to identify tiny non-quantitative signals or relational properties that produce effects; that is, in a purely qualitative manner. In scientific literature, the term information is used to refer to the same properties. It can name the physiological stuff, various quantitative energies, and as well tiny qualitative signals which we can determine exist only through their actions. The term "qi" is at the heart of the ability of traditional theory to describe the web of nature's relations. The term "information" is likewise at the heart of the ability of modem science to describe the web of interactions now known to exist within nature. The term qi is used to refer to and describe both mental, emotional, and physical phenomena. The term information is also used in this non-dualist manner. The parallels of use, meaning, and context are numerous. Systems theory and information theory languages are clearly able to describe the paradigmatic world view assumptions of traditional Chinese theories. Thus, these languages and their theoretical frameworks meet the criteria for the development of a model that encompasses both the Western and Eastern paradigms, allowing logically consistent descriptions and the formulation of experimental procedures adequate to both models. · It is here, in the development of a model of acupuncture and East Asian medicine using systems and information theory models, that Dr. Manaka has made his most valuable contribution. Coming from his background of science, Manaka studied acupuncture and East Asian medicine extensively. Through years of clinical treatments, study, and research, and through the development of numerous innovative techniques, he arrived at a coherent model of acupuncture as a method of modifying the biological information systems. This idea culminated in the publication of a landmark paper in March of 1986.25 By implicitly recognizing the problems and contradictions between Western scientific practices, theories, and methods, and Eastern scientific practices, theories, and methods, he avoided the pitfalls that had trapped most researchers in the field of East Asian medicine and acupuncture. Further, by recognizing the far reaching implications of systems theory and information theory, and adapting them so as to describe the traditional Eastern framework, he developed a model connecting both Eastern and Western systems without contradicting either. This, in turn, has

Introduction

xxiii

allowed for systematic examination and testing of traditional theories and practices, something which is sadly missing in most current research. Manaka focused on the demonstration of anomalies - phenomena not explained in the scientific paradigm and thus was able to achieve significant progress in the study of traditional concepts. Manaka's model, still in its infancy, recognizes the following:

- Qi is difficult to measure and define. In the traditional literature it is an important concept and can be modeled after the concept of information. It does work and brings about (functional) change. - Qi, information, flows through the body in organized patterns, through pathways, generally the jingluo, the channel systems. Jingluo allow interpenetration of information from the superior to inferior, anterior to posterior, left to right, exterior to interior, and vice versa. (This is most evident in Manaka's octahedral model of the channel system.) It allows for the distribution of information throughout the body.

- Jingluo, information channels, may represent biological structures or systems that developed early in evolution and through embryological development. As such, it may be that they are regulated by simple rules and systems that have been in existence before the development of more advanced and sophisticated regulation systems, like the nervous and hormonal systems. Yin-yang antagonisms seem to define one such set of rules. The five-phase system seems to define another set of rules and systems. These may represent primitive biological systems or organizing principles that function in the global regulation and distribution of information. - Yin-yang and five-phase systems are operationally defined by signals. These signals have a very low energy content, but high information content. These signals can be changed or modified by applying appropriate low-energy signals to loci, the xue or acupoints of the channels. Specific acupoints are receptor sites for specific signal inputs; that is, they have yin-yang, five phase, and other characteristics. Thus, very exact changes in the channels and flow of information can be brought about with appropriate signals at the appropriate loci. -Essentially, this information system upholds the known physiological systems as a more primitive regulatory system. Ideas such as these have been alluded to by other authors, but not in such depth and detail, and usually only as a theoretical modei.26 Manaka's models key explicitly into methods of diagnosis and treatment thus representing a unique combination of theory, research, and practice. It should be noted that each stage and statement in the model is both theoretically justified by the traditional medical literature and verified by clinical research and clinical efficacy. This can be said for no other model. Dr. Manaka has called this the "X-signal system;" "X" because the exact nature of the signals are usually not known. While Katsumata and I speculate on the possible nature of these signals (see appendices 4 and 6), it is interesting to notice another parallel in structure. In the Dao De Jing of Lao Zi, the famous first line states: "The dao that can be spoken of is not the eternal dao." Perhaps in anticipation of future developments, Dr. Manaka has recognized the essentially unknowable nature of the signals. This model not only recognizes paradigmatic differences between Eastern and Western world views, it also addresses significant epistemological problems. The methods by which we inquire into or gather knowledge about nature -the decisions and judgments that sit behind what we will inquire about, how we will inquire into it, and by what standards or guarantors we judge our

xxiv

Introduction

inquiry as successful - are very important. John Ratcliffe from the University of California at Berkeley has written an important paper relative to these issues.27 He argues that the dichotomy between quantitative and qualitative research is false; all research is essentially qualitative, since subjective judgments lie behind all the facets of research: All data are theory-, method-, and measurement-dependent. That is, 'jacts" are determined by the theories and methods that generate their collection; indeed, theories and methods create the facts. This means that how the problem will be defined, which model(s) of inquiry will be considered to be relevant to the problem as defined, where one shall look (and, by implication where one shall not look) for evidence - and even what one shall consider to be constitutive of evidence - are all determined by the paradigmatic "map" or world view to which the scientist is committed.

Judgments made by the researcher determine what will constitute knowledge. The guarantor of validity, that which is judged to be sufficient evidence, determines the acceptability of observed data as fact. It is interesting to note that these guarantors of validity have, over the centuries, gone through several evolutionary steps. Ratcliffe notes that the first inquiry system establishing a guarantor of validity was that of Liebniz, using the deductive system through which truth is grasped by analytical deduction. This was followed by the Lockean system, the inductive method, where truth is established through experience, that is, through empirical content. This was followed by the third system, Kant's synthetic system, where truth is established through a combination of the inductive and deductive inquiry systems. Hegel's dialectical system is the fourth system. Here truth is seen primarily as a function of conflict. This is a method that allows a further synthesis of the earlier systems. The fifth and most recent inquiry system is that of Singer, the relative inquiry system. This explicitly recognizes that assumptions, world views, govern the knowledge gathering process, that truth does not exist independent of the human mind. Thus, all truth is only true relative to the goals and objectives of the inquirer and inquiry. Each of these inquiry methods have specific uses today, being appropriate for tackling specific problems.28 Since traditional acupuncture, as well as we can determine, came with no inquiry methodology that we know of, it is important to determine our own methodology for investigating acupuncture and East Asian medicine. If we come to the study of acupuncture with preconceptions of what it is, how it might work, and with what methods it may be studied, we must also come with a considerable knowledge of its theories and practices. If not, we limit the scope of our study enormously and devalue whatever pronouncements our studies produce. Virtually all acupuncture research falls short of these requirements, either because the experimenter lacks knowledge, or because the inquiry methods applied to specific problems are inappropriate. This is not a reprimand, more a statement of fact. Almost all researchers in the field have come to their studies with good intentions, but almost none have asked the basic research questions. Since, as we have seen, the traditional Chinese world view is similar to the emerging twentieth century world view, the fifth inquiry method, the relative inquiry method, is most appropriate. This allows the theoretical components of the traditional theories to be treated seriously by the inquirer.29 Unfortunately, this is rarely the case. While Manaka did not use Ratcliffe's labels, he adopted a relative approach, taking all theoretical concepts seriously until they were shown to be either wrong or trivial. Further, he developed a flexible approach to his studies. This allowed him to examine many components of the traditional systems.

Introduction

xxv

In his study of acupuncture, Dr. Manaka brought a unique combination of knowledge and methods. He had a deep knowledge of the traditional literatures. In his large library he had all the major classics and their commentaries, as well as many texts on acupuncture from countries around the world. He was fluent in Japanese, Chinese, German, French, and English, with research skills in several other languages. He had an in-depth knowledge of the most significant traditional, integrationist, and scientific approaches to practice. He had detailed knowledge of the paradigms of both Western scientific medicine and traditional East Asian medicine, and was fluent in the paradigmatic conflicts. He also had a good working knowledge of theories on the cutting edge of science and an incredible knack for developing models and methods. This book is a product of his rare combination of skill and knowledge. Manaka was the first to have tested acupuncture on its own terms and to have developed scientific models not paradigmatically at odds with the theories and methods they set out to explain. This is truly a unique and valuable contribution. Others, such as you and I, must now undertake the daunting task of rigorously exploring Manaka's theories and claims. But only if we persevere will progress be made and will acupuncture attain its true potential. We cannot be so rich to disperse enough money to everyone. But we can be wise enough to enrich other people's knowledge with our own mental devotion. - Yoshio Manaka, 1987 STEPHEN BIRCH VVAL~,~SSACfnJSETTS,

1995

NOTES 1 A comprehensive reference listing of citations and abbreviations appearing in this introduction may be found following these notations. 2 Nathan Sivin has good discussions of this point: "One of the explicit aims of the Great Proletarian Cultural Revolution became to produce a synthesis of the two systems [i.e., the traditional and scientific] that would be fully scientific without being foreign or elitist." See Sivin, N., Traditional Medicine in Contemporary China, Ann Arbor: Center for Chinese Studies, 1987, p. 19. See below for further discussions of this point. 3 See for _example: Mann, F., Acupuncture: The Ancient Chinese Art of Healing and How it Works Scientifically, New York: Vintage Books, 1973; Gunn, C.C. et al, "Acupuncture loci: A proposal for their classification according to their relationship to known neural structures," Amer. Jour. Chin. Med. 4 (2): 183-195 (1976); and Ulett, G.A., Principles and Practice of Physiologic Acupuncture, St. Louis: Warren H. Green Inc., 1982. 4 See for example: Han, J.S., The Neurochemical Basis of Pain Relief by Acupuncture, Published privately by the author at Beijing Medical University. See also the books of abstracts from China, e.g., Anon., National Symposia of Acupuncture and Moxibustion and Acupuncture Anesthesia, Beijing, China, June 1979. 5 For examples of this in English, see: Kaptchuk, T., The Web That Has No Weaver (chapter 2), and The Essentials of Chinese Acupuncture, (p. 36). Nathan Sivin's translation of the Revised Outline of Chinese Acupuncture, in his publication, Traditional Medicine in Contemporary China, renders perhaps the most dil'ect expression of the modem Chinese opinion on this subject. This text states, for example, that "Ch'i, blood (hsueh), ching, and the dispersed body fluids (chin-yeh) are the indispensable material foundation of the body's vital activities"; and again, "Ch'i has two senses; one is physiological function or motive force and the other is subtle, refined matter which has a nutritive function." Sivin is very aware of the absurdity of this terminology - material foundation, refined matter, etc. He footnotes his own disagreement: "This account, although typical of recent writing, differs considerably from the classical understanding," and refers the reader to his discussion of the subject. See: Sivin, N. op.cit. p. 237. 6 Voll, Reinhold. "Twenty years of electroacupuncture diagnosis in Germany; a progress report," Amer. J. Acup. 3: 7-17 (1975); Voll, Reinhold, Special EAV issue, Amer. Jour. Acup. (1978). See also, Nakatani, Y. and K. Yamashita, Ryodoraku Acupuncture, Tokyo: Ryodoraku Research Institute, 1977.

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Introduction

7 See Nigel Wiseman's immense and important work, the Glossary of Chinese Medical Terms and Acupoints. In addition, see Paul Unschuld's important contributions to the field, Medicine in Ch~n.a: A History of Ideas; Medicine in China: Nan Ching: The Classic of Difficult Issues; and Approaches to Trad1tzonal Chinese Medical Literature. Joseph Needham made some interesting early comments on the problem of translation in East Asian medicine in his mid-1970's critique of Manfred Porkert's approach to the problem. See Needham, J., and Gwei-Djen Lu, "Problems of translation and modernisation of ancient Chinese technical terms," Annals of Science 32:491-502 (1975). 8 See Wiseman's translations and works based on his translations, including Fundamentals of Chinese Medicine, Fundamentals of Chinese Acupuncture, Grasping the Wind, Glossary of Chinese Medical Terms, and Illustrated Chinese Materia Medica. 9 See Unschuld's numerous translations, including Medicine in China, A History of Ideas; Medicine in China, the Nan-Ching Classic of Difficult Issues; Medicine in China, A History of Pharmaceutics; Medical Ethics in China; and Forgotten Traditions in Ancient Chinese Medicine. 10 Good discussions of this can be found in the following articles: Ikemi, Y., and A. Ikemi, "An oriental point of view in psychosomatic medicine," Advances 3:4 (Fall1986), pp. 150-157; and Shen, G.J. "Study of mind-body effects and qigong in China." Advances 3:4 (Fall1986), pp. 134-142. 11 Chiu, Martha Li, Mind, Body, and Illness in a Chinese Medical Tradition, Ph.D. diss., 1986, p. 165. 12 See for example, Huang Di Nei Jing Su Wen, chapter 5; Essentials of Chinese Acupuncture, p.45. Good discussions can be found in Shen, G.J .. "Study of mind-body effects and Qigong in China," op.cit. 13 Mention can be found in the Introduction of Acupuncture: A Comprehensive Text, p. 2. There is a further reference to this idea - though less directly stated - in the Introduction to Fundamentals of Chinese Medicine, pp. xxi-xxii in particular. 14 Unschuld, Paul, "The dual approach to healing in Chinese medicine: Ontological and functional understandings of illness," lecture given at the New England School of Acupuncture, April 11, 1989. See also: Unschuld, Paul, "Traditional Chinese medicine: Some historical and epistemological reflections," Soc. Sci. Med. 24:12 (1987), pp. 1023-29. More recently see, "Epistemological issues and changing legitimation: Traditional Chinese medicine in the twentieth century," in Leslie, C., and A. Young, Paths to Asian Medical Knowledge, Berkeley: University of California Press, 1992. Other authors have drawn attention to the "mechanistic" and thus causal nature of many of the early medical speculations. For an interesting and thorough discussion, see Epler, D.C., "Bloodletting in early Chinese medicine and its relation to the origin of acupuncture," Bulletin of the History of Medicine 54 (1980), pp. 337367. 15 Questions like this have been asked by some authors, typically not in the primary acupuncture literature, but rather in secondary literatures. See e.g., Aakster, C.W., "Concepts in alternative medicine," Soc. Sci. Med. 22:2 (1986), pp. 265-273. See also, Patel, M.S., "Problems in the evaluation of alternative medicine," Soc. Sci. Med. 25:6 (1987), pp. 669-678. 16 In the Essentials of Chinese Acupuncture (p. 11), yin and yang are described as a "naive concept of materialism and dialectics." In Fundamentals of Chinese Medicine (p. 18), yin-yang and five-phase theories are described as being based on rudimentary dialectics and necessarily incomplete. In the Zhongyi Mingci Shuyu Xuanshi (p. 1 p, p. 7 p), edited by the Chinese Medical Research Institute of the Guangdong Chinese Medical School (People's Hygiene Publishing Company, 1973), yin-yang and the five phases are described as primitive dialectical materialism. Perhaps the originators of yin-yang and five phase theories did not have Marxist dialectics in mind. Historically, at least, it would be better to say that Marx (albeit unintentionally) had Chinese philosophy in mind. Kaptchuk states the problem well in his Introduction to the Fundamentals of Chinese Medicine, p. xxxiv-xxxv:

The self justification of East Asian medicine was taken outside of its own methodology. By appealing to a combination of 19th century shallow positivism (i.e. "empirical practices of the masses") and 20th century watered-down dialectical materialism (i.e., "yin-yang is a rudimentary dialectic"), East Asian medicine ceased to be a coherent point of departure for illness and health and became a corpus needing rescue from modern science. The tendency that has existed for the last thirty years in China to be "interested in the empirical efficacy of traditional practice, not in the traditional theoretical framework, which supported these practices," reached full bloom . ... China's synthesis (which itself is always changing and itself has been affected by Western questions and research) is the product of complex cultural, historical and political forces. 17 For good discussions of this theorem see Dossey, Larry, Space, Time and Medicine, pp. 98-101, and Capra, Fritjof, The Turning Point, pp. 83-85. 18 David Bohm, Wholeness and the Implicate Order. See also: Ken Wilber, ed. The Holographic Paradigm and other Paradoxes.

Introduction

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19 For good discussions of this see: Gleick, James, Chaos, Making a New Science; Prigogine, llya, and Isabelle Stengers, Order out of Chaos; Davies, Paul, The Cosmic Blueprint; Mandelbrot, Benoit, The Fractal Geometry of Nature; also Foss and Rothenberg, The Second Medical Revolution; and Dossey, Larry, Space, Time and Medicine. 20 We are certainly not the first to draw attention to and use these parallels. The physicist Wing Y. Pon, a native Chinese living and working in California, has developed models using exactly these parallels. Some of his work was published privately, most is not yet published. See for example: Pon, Wing Y., Journey into a Science of Reality I-III, San Jose: East West Institute for Sciences and Philosophy, 1978. His use of these recently developed conceptual frameworks is unparalleled in my knowledge. 21 Cunningham, A.J., "Information and health in the many levels of man: Toward a more comprehensive theory of health and disease," Advances 3:1 (1986), pp. 32-45. 22 Ibid. 23 Foss and Rothenberg make the most extensive and cogent argument regarding these developments and their necessary inclusion in the medical model. They develop the notion of "infomedicine," rather than biomedicine, which they see as necessarily containing all the restrictions of modem science not grounded in twentieth century physics, where the infomedical model has none of these disadvantages. This is discussed throughout the Second Medical Revolution. Many other authors have used similar models and analogies. See for example: Capra, Fritjof, The Turning Point, pp. 265-304; Cunningham, A.J. "Information and the many levels of man: Toward a more comprehensive theory of health and disease," Advances 3:1 (1986), pp. 32-45; Engel, G.L., "How much longer must medicine's science be bounded by a seventeenth century world view?" in K.L. White (ed.), The Task of Medicine, Menlo Park, California: Henry J. Kaiser Family Foundation, 1988, pp. 113-136. For discussions of the biological extensions of these models, see for example: Schoffeniels, E,. Anti-Chance; Brooks, D.R. and E.O. Wiley, Evolution as Entropy. For interesting discussions of the origin of information, see: Gleick, James, Chaos, Making a New Science, pp. 255-262. 24 See for example: Ikemi,Y. and A. Ikemi, "An Oriental point of view in psychosomatic medicine." Advances 3:4, pp. 150-157, 1986. See also the works of Wing Y. Pon referenced above. 25 Manaka, Y. and K. Itaya, "Acupuncture as intervention in the biological information system. (Meridian treatment and the X-signal system)," Address given at the annual assembly of the Japan Meridian Treatment Association, Tokyo, March 29-30, 1986. Published in English in the Journal of the Acupuncture Society of New York 1:324, 9-18, 1994. In this paper he proposed that a low-energy signal system comprises the essence of the theories and effects of acupuncture. He provided preliminary evidence for this model from theoretical and experimental biology and his clinical research and practice. 26 For example, several Chinese researchers have concluded after extensive reviews of current research that the channels must be a "higher and more complicated system" linking all other systems in the body together. See Zhao Jianguo and Zhang Linying, "Review of the current status of acupuncture and channel theory," Amer. Jour. Acup. 14:2 (1986), pp. 105-109. One Chinese researcher has proposed that the channels function as a "third equilibrium system" which mediates between the body surface and the viscera. See Meng Zhaowei, "The third equilibrium system-meridian system," Jour. Chin. Acup. Moxib. 1:1-2 (1987), pp. 62-64. Other Chinese authors have proposed that the channels of acupuncture function as a "latent information feedback network of the human body's regulating systems," where information about the body's current state is conveyed by the channels between "special cells" that lie along its path, producing general regulatory effects in the body. See Chong Jang Xia and Jia Rui Lin, "A new kind of stimulator for dredging human body's channels," IEEE Eng. Med. & Bioi. Soc. lOth Annual Int. Con£. (1988), pp. 1250-1251. Other authors and researchers from different parts of the world have arrived at similar conclusions. William Tiller, in reviewing the literature and uses of electrodermal instruments, has drawn a model showing how it might be possible for information about the state of function of the internal organs to reflect to acupoints at the skin surface, and how information can be sent back from these points to their corresponding organs to produce functional changes. These points at the surface "become information access windows to the functioning state of specific organ and body systems." See Tiller, William, "On the evolution of electrodermal diagnostic instruments," Jour. Adv. Med. 1:1 (1988), pp. 43-72. Some researchers in Austria have specifically related the systems of acupuncture to "systems theory" and proposed physiological models that match these theories. See Feigl, W. and E. Feigl, "The pathophysiology of acupuncture: An abstract," Amer. Jour. Acup. 13:3 (1985), p. 280, originally from the Deutsche Zeitschrift fur Akupunktur 28:2 (1985), pp. 36-40. 27 Ratcliffe, J.W., "Notions of validity in qualitative research methodology," Knowledge, Creation, Diffusion, Utilization 5:2 (1983), pp. 147-167. 28 Ibid. 29 Ibid., p. 157.

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Introduction

ABBREVIATIONS USED IN THE INTRODUCTION [AC]: E. Schoffeniels, Anti-Chance. [ATP]: Baldry, P.E., Acupuncture, Trigger Points and Musculoskeletal Conditions. [CB]: Davies, Paul, The Cosmic Blueprint. [Cha]: Gleik, James, Chaos, Making a New Science. [ECA]: Essentials of Chinese Acupuncture [EV]: Matsumoto, K. and S. Birch, Extraordinary Vessels. [FCM] Wiseman, Nigel, et al., Fundamentals of Chinese Medicine. [FE]: Matsumoto, K. and S. Birch, Five Elements and Ten Stems. [HD]: Matsumoto, K. and S. Birch, Hara Diagnosis: Reflections on the Sea. [MCHI]: Unschuld, Paul, Medicine in China: A History of Ideas. [SCC]: Needham, Joseph, Science and Civilization in China. [SMR]: Foss and Rothenberg, The Second Medical Revolution. [SSR]: Kuhn, Thomas, The Structure of Scientific Revolutions. [STM]: Dossey, Larry, Space, Time, and Medicine. [SW]: Su Wen [TaoP]: Capra, Fri~of, The Tao of Physics. [TurP]: Capra, Fri~of, The Turning Point.

GLOSSARY OF TERMINOLOGY

A meaning of a word is a kind of employment of it. Giving grounds, however, justifying the evidence, comes to an end; but the end is not certain propositions striking us immediately as true, i.e. it is not a kind of seeing on our part; it is our acting, which lies at the bottom of the language game. -

Ludwig Wittgenstein, On Certainty

I ·am not a translator, I am a collector of ideas. I have helped describe and collate the ideas in this book, but do not claim the role of professional translator, nor is this book essentially a work of translation. The use of terms that are not of English origin is Dr. Manaka's, whose written English was excellent. Thus, I have transmitted his ideas as best I could in terms that strove to express his understanding. The Japanese, no less than the Chinese, use the characters of written Chinese. Thus Japan has never needed translations in the sense these are required in the West. Furthermore, this is not a generic work where the language must reflect the cultural scope of Chinese medicine, but a specific attempt to define ideas like qi, yin-yang, and five phases- something rarely attempted. As well, while Dr. Manaka clearly understood that written translation resources are essential for insuring the public access and scrutiny that Eastern no less than Western sciences require, he supplied this work with practical tests that others may confirm. For these reasons, very few comments on the use of terminology in this text are required. First, the viewpoint and assumptions of an inquirer cannot be separate from the inquiry. Translation and speculation are both methods of inquiry. To use terms which have technical meanings, without providing a glossary of technical definitions, is an invitation to misunderstanding, as readers assume that their own understandings apply. Failure to define is thus at best confusing; at worst, it completely invalidates the information. To use terms that have origin in another language, and thus depend on the assumptions of the inquirer to great extent, without providing the assumptions that lie behind the translations, is hardly honest. There are a number of terms used in the text that come from the traditional Chinese literatures. These have either been translated or only romanized. Terms such as qi and yin-yang are probably untranslatable in the usual linguistic sense. Indeed, as is argued in the text, it may be the language of mathematics that most effectively translates these terms. These terms typically feature in discussions throughout the text and are explored through analytic and comparative means; for example, describing how qi shares much with the concept of information. However, while translating the word qi as information would dramatically make that point, it would reflect a grandiosity quite unlike Dr. Manaka.

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Glossary of Terminology

Terms such as jing luo, wu xing, jing jin, bu, xie, shi, xu, have been translated in a variety of ways that depend on the viewpoints of various authors. ]ing luo are variably translated. The first European attempt came from France where they were translated as "meridians." Other common translations include "channels and collaterals," "channels and connecting channels," "conduits," "conduits and network vessels." A brief study of the etymology and use of these terms showed that they each capture some, but not all, of the meaning of the Chinese. For example, the term "meridian" has implications associated with celestial movements, the division of the heavens by invisible lines, and by extension, lines of force. The term channel generally refers to some pathway along which fluid moves, and secondarily has meanings such as "channels of information." The term conduit is not that dissimilar to the term channel, except perhaps in being more specifically used. Each of these words captures some of the connotations of jing luo. They have been analogized to passageways of water as the qi flows through them, a fact confirmed by the names of important acupoints. They are also insubstantial and nonvisible, and define the surface of the body from top to bottom, section by section. How to decide which term is most appropriate? Dr. Manaka used the term "meridian" when speaking or writing in English because this was the word commonly used by the English speakers he first encountered. The term seems to imply something more subtle, less gross than a channel, which is usually something tangible with a definite shape, depth, and size. "Meridian" implies a logical rather than physical quality. However, the argument that information flows in channels is telling, particularly since Manaka's work shows that the jing-luo are passageways for the flow of something (e.g.: signals, information). Thus, I decided on the term "channel." The term wu xing has been translated elsewhere as "five elements." While there are some who still wish to justify a relationship to the Western ideas of elements, this translation is now generally recognized to be less accurate than "phases." Phase implies change and interaction, key features of this logical system, where element carries with it the sense of immutability that is at the conceptual root. Manaka used the term phases and his research seemed to show that the wu xing are something similar to a phase. Manaka's own term, "isophasality" has been reserved for technical presentations of his ideas. Again, the practical value of an easily recognizable differentiation between the classic term and the proffered theory is of some value. The jing jin are more difficult; in the past they have been translated by European authors as the "tendino-muscular" meridians or channels. Recently they have been rendered as the "channel sinews" or "muscle meridians" or "conduits." The term jin seems to refer to anatomical structures that include the tendons, ligaments, muscles, and all the other associated structures, such as nerves and blood vessels. The term muscle is thus a limitation of scope. However, by extension it does include other related structures. The term "sinew" is relatively broad and encompasses all these structures. However, those who want a more physical and less functional reference to musculature do object. "Sinews" refer to the tendons in most medical dictionaries. The term "tendino-muscular" is interesting, but limited. In anatomical literature the term one encounters is "musculotendinous" not "tendino-muscular." I used the term "channel sinew" for this text because of the following considerations. First, Unschuld uses the term muscle with a footnote that defines this as including the sinews; Needham takes note of the nature of the jing jin as being neuro-muscular; Shibata argues that the term jin refers to the muscles and all their associated structures, tendons, ligaments, nerves and blood vessels. Thus there is good precedence among those who have offered a rationale.l

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The terms bu and xie used to be translated as "tonification and dispersion" or "tonification and sedation," and are more recently translated as "supplementation and draining." In this particular case, Dr. Manaka's clinical experiments and explorations determined the choice. In chapter one he explores the concept clinically and experimentally, rather than pedagogically (as we are doing here). This investigation shows that in any of these translations there is a great inadequacy, because they do not match the experimental results. As a consequence, the terms only appear when discussed where they are translated as "supplementation and drainage." The terms do not appear in the clinical sections, because the treatments there have different goals; they are designed to regulate the signal system, not to add to or subtract from the physiological system. The terms shi and xu suffered the same fate. Translations such as "excess and deficiency," "repletion and vacuity," "repletion and depletion" do not fit clinical and experimental findings. In the text, when they are encountered, they are rendered as "repletion and vacancy" because that was Manaka's choice, but then are shown to be neither. Surprisingly, this covers almost all the traditional terms that appear in the text. What is unique in Dr. Manaka's approach is that rather than pure scholarly and pedagogical analysis, he designed clinical experiments to explore the meaning of the terms. Most of the time he has found that the terms really do correlate to some entity or functional system, but often in a manner different than the implications of the popularly used English words. For those interested in the translation of terms from the Chinese, Nigel Wiseman and Paul Unschuld's contributions are by far the most significant.2 In the text proper, whenever the words "I" or "my" are used these terms refer to Dr. Manaka. Whenever the term "we" is used, it refers to Manaka and Itaya. I have tried to keep myself out of the text as much as possible. The reader will find a few notes that begin "S.B." This is where I thought I could clarify the text. There are other terms which arose in the Western literatures, especially scientific terminology not often encountered in the study of acupuncture. Often the text itself provides these definitions. Our reasons for inclusion of these terms in this text are numerous, but can be summarized as an attempt to highlight fundamental issues and formulate clear and sufficient models upon which and to which research can be carried out. We have selected theoretical paradigms and models that use languages capable of solving or avoiding these fundamental problems, i.e., capable of bridging the differences. These often utilize mathematical terms and concepts derived from theories that are forging new horizons in the fields of physics and biology. The following is a brief explanation of some of the terms used in this text. To a specialist knowledgeable in a particular area, these definitions will be inadequate since they are meant as summary explanations. References have been provided for readers wishing to research further. Finally, it should be noted that this text discusses many specialized techniques not yet described extensively in English, such as the techniques of Japanese needling, moxa, moxa on the head of the needle, intradermals, bloodletting, cupping, the Manaka wooden hammer and needle (peg), and the use of the Hirata zones. Readers desiring additional information regarding clinical applications of these techniques may look to a subsequent title, Birch, S. and J. Ida, Japanese Acupuncture, A Clinical Handbook, Brookline, MA: Paradigm Publications, 1995. STEPHEN BIRCH

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Glossary of Terminology

TERMINOLOGY DISSIPATIVE STRUCTURE: This term was first coined by Ilya Prigogine, who received a Nobel prize for his work on dissipative structures. It refers to a system's use of entropy (see below) for maintenance and development. In a closed system, order slowly breaks down and entropy ensues, but in the real world where open systems are the rule, systems interact continuously with their environment. This allows a continuous exchange of energy between the system and its environment, which is believed to underlie the development of order in the system. This is most clearly seen in systems that are far from equilibrium, i.e., that are on the brink of chaos. In these states, systems show self-organizing properties that push the system into a newly ordered state; they dissipate energy into the environment, allowing order to develop with the energy remaining in the system.

"A dissipative structure evades the degenerative effects of the second law lf thermodynamics- see also below] by exporting entropy into its environment."

Dissipative structures interact and exchange with their environment. "In all cases the system is driven from equilibrium by an external forcing agency, and adopts a stable form by dissipating away any perturbations to its structure. Because energy is continually dissipated, a dissipative structure will only survive so long as it is supplied with energy (and perhaps matter too) by the environment."4 ENTROPY: In a broad sense, entropy refers to a state of disorder in a system. The higher the entropy, the greater the disorder. The second law of thermodynamics states that the entropy of a closed system will increase over time. In a narrower sense, entropy is a measure of a system's unavailable energy. The more entropic a system is, the less available energy there is in the system. Recent studies in chaos have called the second law of thermodynamics into question, since it has been shown that the state of chaos (disorder/entropy) contains within it the seeds of order, or hidden orders. Chaotic systems can spontaneously give rise to ordered systems.S HOLOGRAPHY - HOLOGRAM, HOLOGRAPHIC PARADIGM, HOLOMOVEMENT:

Holography is the study of three-dimensional images created using light waves that interfere with each other. The image created is called a "hologram." An interesting fact about holograms is that each portion of the hologram contains within it an image of the whole hologram. This unusual feature has led a number of researchers in various fields to speculate that holographic modeling may explain how "holistic models" work. For example, the brain may use holographic modeling.6 The physicist David Bohm has gone much further in his modeling of nature. He argues that the entire universe is a hologram. 7 This model has allowed him to explain and resolve certain difficulties in experimental physics. The new model that he (and others) have evolved is called the "holographic paradigm" (see below for discussions of "paradigm.") The importance of this model is that it allows descriptions of how non-local events can produce local changes and how local events can produce non-local changes, that is, how every part of the universe communicates with· all the other parts of the universe. The term "holomovement" refers to that which carries the information specific to an "implicate order" (see below) in an undivided and unbroken totality. HOMEOSTATIC MECHANISMS- FIVE PHASE, YIN YANG INTERACTIONS: A homeostatic mechanism is a mechanism that serves to restore an original state of a system. In biological organisms homeostatic mechanisms are extremely important, since most biological activities occur within very narrow biochemical and thermal limits. Optimal biological activities are maintained when the homeostatic mechanisms are

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xxxiii

able to keep the internal environment within those limits. Any shift outside those limits can lead to decreased biological activity and malfunction, that is, disease. In the earlier chapters of this text we will show how many of the traditional Chinese theories, such as the five phase and yin yang theories, are partially descriptive of how the body regulates itself.

Yin yang interactions describe how antagonistic/syntagonistic parts of the body regulate each other, or at least how those antagonistic/syntagonistic parts can be utilized therapeutically to initiate such regulation. In the "octahedral structure" (see below), the yin yang antagonistic halves of the body serve to regulate the overall distribution of qi around the body. When problems occur, treatments can be given that activate these regulatory functions to restore a healthier balance (e.g., the general distribution of qi around the body.) The five-phase interactions also describe how different functional systems within the body regulate the activities of other functional systems. If one phase goes out, the others function to return it to its more normal state. Should this be insufficient, such that pathologies occur, treatments may be devised to activate the phasal interactions, thus helping the whole system restore a more normal state of balance. These two regulatory mechanisms represent significant first line homeostatic mechanisms in the body. {The nature of these phasal interactions and regulatory functions are analyzed mathematically in appendix 5.) INFORMATION- THEORY, SYSTEMS, FLOW: Information is a general term that refers to both energy and matter. It occurs within organisms and between organisms. In more general terms, it occurs within and between systems (see below); it describes the interactions between parts and wholes, between systems. Information theory is a theory that uses the concept of information to make broad statements about the object of the theory. "Information" is a complex concept that has been given various definitions in such fields as thermodynamics, communications and probability theory. Generally speaking, it is a measure of the order existing in a system - a certain degree of order represents information - and it implies the deliberate selection of one event out of a number of possibilities . ... Information is any pattern of events in time and space. ... The form or structure of the body has informational content.B In the sense of traditional physics, information is neither matter nor energy. Rather, the concept of information brings into play the two older antipoles of matter - namely, form and consciousness. . . . One must take "probability" and "information" as objective and, at the same time, as subject-related concepts.9

The term "information" and the informational view of nature are becoming increasingly central in science and in medicine. Basically, use of the term "information" allows descriptions of systems and the complex interactions within and between systems, in such a way as to give more accurate descriptions of the processes at work. It allows a logical description of nature in more comprehensive or holistic terms, which is more in keeping with experimental physics than the seventeenth century world view still prevalent in much of the scientific community. Many in the medical community demand the full development of information theory in medicine. The infomedical model is becoming more important as a replacement for the traditional model.lO IsoPHASALITY: This term was first coined by Dr. Manaka in relation to the ancient Chinese theory of the five phases. Each phase is described as having a series of (horizontal) interactions with each other phase, for example, the engendering and restraining cycles. Within each phase numerous (vertical) correspondences are described. For example, each phase has corresponding organs, channels, colors,

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Glossary of Terminology

sounds, tastes etc. In its broadest sense, the term "isophasal" refers to these vertical sets of relationships or correspondences. In a narrower, more clinically oriented sense, the term refers to a set of same (iso-) phenomena. For example, each meridian has an "earth" acupoint on it. These earth acupoints are all isophasal to each other. This means that they all manifest some similar characteristics. A specific signal produces the same response at all these acupoints but not other acupoints. For example, the color yellow when applied to earth acupoints elicits the same response from each meridian to which it is applied, but not at any other acupoints. A technical definition of the term can be found in chapter six. The term is occasionally used outside the field of acupuncture. (It does appear occasionally in topological theories and models; see below for a brief discussion of the term "topology.") MAGNETIC POLES: In this text we use the terms "north magnetic pole" and "south magnetic pole". We denote the north magnetic pole as a positive polarity agent, and the south magnetic pole as a negative polarity agent. In the context of our discussions, the north magnetic pole of a magnet is that pole of a magnet which repels the points of a compass, while the south magnetic pole of a magnet is that pole which attracts the point of a compass. This is based on the idea that the geographic north pole of the earth is the geomagnetic south pole. If one is using magnets that are denoted opposite to this definition, one would expect to see the reverse reactions to those described in this text. OCTAHEDRAL THEORY OF STRUCTURE-FUNCTION REGULATION: This theory was first formulated by Dr. Manaka. It refers to the ancient yin-yang categorizations of the body into antagonistic halves, for example inferior-superior, anterior-posterior. Examples of this ancient categorization have appeared in medicine and biology (see chapter five). Our own testing of the body also has shown these antagonistic tendencies (again, see chapter five.) Clinical methods designed to take advantage of these ideas have proven useful and have led us to formulate the theory that there is a hidden structure or symmetry in the body that probably arose early in evolutionary and embryological development. This structure is more a kind of "structure-function" regulatory mechanism; e.g., in traditional terms, the circulation and distribution of qi is regulated in part by this yin-yang, antagonistic-syntagonistic structure. ORDER- IMPLICATE ORDER, EXPLICATE ORDER: The term "order" has multiple meanings. In this text, the term is used primarily to describe or refer to the state and degree of structure of a system. The more "ordered" a system is, the greater its internal structure and the more the functions or purposes of the system can be realized. Entropy, disorder, or chaos refer to the breakdown of the structure of the system. In most instances, diseases or pathological conditions could be characterized as a breakdown of the order of the system and an increase of the disorder of the system. Order also implies a set of rules that govern the system's behavior. Many times these rules are known, and can be described, in the terms of David Bohm, as being of the "explicate order." Many times the rules are not apparent or are unknown, or hidden. These can be described, again following David Bohm, as being of the "implicate order." We have found, for example, that there are "hidden orders" in the body, hidden structures, which have functions that do not normally manifest, i.e., are not clearly apparent to us. In the octahedral structure model (see above), we have found just such a hidden order, a structure hidden in the body which seems to have important regulatory functions in the body (see chapters three and five for details).

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PARADIGM: A paradigm is a pattern or model. In the context of this work, the term "paradigm" refers to the system of world views which comprise the model of nature or the world held by a culture or group of people. The ancient Chinese system of world views is quite different from the world views underlying modem Western cultures. What lies behind these systems of world views are different sets of assumptions about how the world is. For example, since at least the seventeenth century, one of the Western assumptions about nature has been that the world, and all things in it, are reducible to their component parts. Understanding those things is a process of analyzing the parts and compiling the information to reproduce the thing. Typically, but not exclusively, the ancient Chinese made an opposite assumption: one cannot separate anything from the whole web of reactions in which it is immersed in the world, thus one cannot simply reduce an object to its component parts to understand it. Interestingly, with new findings in the field of physics, scientists are also seeing the world now as irreducible, creating what is called a "paradigm shift."ll

SAYOSHI: This term was first coined by Yasumasa Katsumata. In English it means something like "phantom function." When objects are placed close to the surface of a body, the body receives certain influences from those objects. In the living body, these influences are received without the involvement of any conscious or sensory mechanism. All objects have their own specific influences, the functions of which can be transmitted to one object and then from this to other objects. In the living body these functions are different from the known physiological functions. Katsumata has called these functional factors sayoshi. Sayoshi has the following characteristics:

1. It remains in a space after an object has been removed from that space. 2. It can be removed by moving any conducting substance (excluding insulators) over it. 3. It can be carried by one object to another object. This is called the "replication effect." 4. It can be propagated by electromagnetic waves (high frequency current inside the body.) Therefore it can be said that sayoshi is not material. Katsumata calls these electromagnetic waves which carry sayoshi "molecular waves." 5. In the living body, the sayoshi of an object acts on the sayoshi of the body and can produce physiological changes. Sayoshi is a kind of static quality in space, like an electromagnetic or gravitational field. However, electromagnetic and gravitational fields are very much dependent upon the substances that produced the fields, and will be moved with the substance, whereas the sayoshi effect can remain in the space once occupied by the substance that generated it, even after the substance has been removed. This is an essential difference between sayoshi and ordinary known fields. According to Einstein's theory, the already known fields are transmittable in light fields, where they have no stationary mass and do not have energy in a stationary condition. Substances with mass cannot be transmitted to remote places by means of electromagnetic waves. Sayoshi is transmittable by them, but has no mass; thus it cannot have substance. In modem science, all things are composed of either substances and, or fields, all phenomena occur along with these. Sayoshi is neither substance nor field. Consequently, sayoshi is not explicable by any known theories. Appendix 4 has further discussions and examples of the concept of sayoshi, with a mathematical analysis of the vector properties of sayoshi, especially with regards the properties of the acupuncture needle.

xxxvi

Glossary of Terminology

SYSTEMS THEORY - OPEN SYSTEM, CLOSED SYSTEM, SIGNAL SYSTEM: "Systems are integrated wholes whose properties cannot be reduced to those of smaller units. Instead of concentrating on basic building blocks or basic substances, the systems approach emphasizes basic principles of organization."12 Normally our senses lead us to perceive the world in discrete units. We tend to see objects as separate from each other, and from force of habit, we tend not to perceive how things interact with each other. The ancient Chinese world view included the idea that all things interact with each other all the time. The developing scientific world view is the same: all things interact with each other all the time. But our ordinary language is not really capable of describing the world and these interactions like this. Systems theory is a theoretical model that allows just such descriptions. Foss and Rothenberg, in their book, The Second Medical Revolution, have described this in some depth. The use and equivalency of systems theory to the ancient Chinese medical models is explored in the conclusion of Hara Diagnosis: Reflections on the Sea, by Matsumoto and Birch. An open system is a system which exchanges information (energy, matter,) with its environment. All living organisms (systems) are thus open systems. A closed system is a system which exchanges no information with its environment. (See the discussions of dissipative structures and entropy above.) The signal system is a term coined by Dr. Manaka. It refers to a model that he has developed of how things interact, typically at more subtle levels. Information passing between things and within things is generally referred to as a signal. Often the exact nature of such signals are unknown, especially in the field of acupuncture. Hence he has named this the "X-signal system," "X" because of the frequently unknown nature of the signals. This model is important because it has allowed the development of a theoretical model which is equivalent to the traditional Chinese model of acupuncture, and which is experimentally testable. Until considerably more is known of what the ancient Chinese were describing in their medical models, it is premature to limit the scientific description of any of those models to concepts and models available to us now. Typically the technology we use to make our measurements gives limited measurements, making it difficult to be certain that what is measured is the same as that to which the Chinese referred. Until the phenomena clearly associated with acupuncture theory and practice can be more comprehensively analyzed, it is perhaps wiser to use less specific language in describing them, by selecting terms such as "information" or "signals." This at least is reflective of the vagueness of the original Chinese descriptions and is able to resolve some of the paradigmatic differences between the traditional Chinese world views and the traditional (post-seventeenth century) Western world views. (See the introduction to this text for further discussion.) TOPOLOGY - HOMEOMORPH: Topology is the branch of mathematics dealing with three-dimensional geometric forms, both physical and imaginary. It deals with space - the topological space, the phase space - and the properties of solids. In particular it is useful for describing those properties of solids which remain unchanged through a series of different deformations of an object (see chapter 2 for discussions and examples of this). Some of these properties, such as connectedness, allow a description of how the whole system behaves. When an object is deformed by stretching, bending, etc., the old form and new form retain certain properties in common. The two forms are then homeomorphic to each other. Topology is also useful in modem physics in the analysis of complicated electrical networks, for example, and in the analysis of oscillating systems. This last use is important in the growth of studies in the nature of chaos and chaotic rhythms.

Glossary of Terminology

xxxvii

ENDNOTES 1 See for example, Paul Unschuld, Nan Ching: the Classic of Difficult Issues, p. 113; L. Gwei-Djen and J. Needham, Celestial Lancets, p. 51. For a discussion of this issue and Shibata's ideas, see Matsumoto, K. and S. Birch, Hara Diagnosis: Reflections on the Sea, p. 149. This is reinforced by Wiseman's note that he chose "sinew" to preserve the vagueness of jin in Chinese. In the medical literature the symptoms associated with the jing jin are mostly symptoms of muscle pain, muscle spasm, muscle cramps. To exclude the term muscle from the translation might lead the English-speaking practitioners away from the obvious clinical association . But, the jing jin not having been experimentally investigated by Dr. Manaka left me with no choice. The reality that we do not know what, if anything, is in these jing, or whether they may only represent projections of information, perhaps with the signatures described by Williamson and Kaufman, Biomagnetism (op.cit) makes the term "channel sinew" acceptable, since it is less rigidly material. 2 See for example Wiseman's immense work, Glossary of Terms in Chinese Medicine. For Paul Unschuld's contributions, see for example, his Nan Ching: The Classic of Difficult Issues, and the proceedings of the 1986 Symposium on translation methodologies and terminologies edited by Unschuld, in Approaches to Traditional Chinese Medical Literature, Dordrecht: Kluwer Academic Publishers, 1989. 3 Davies, P., The Cosmic Blueprint, New York, Simon and Schuster, 1988, p. 85. 4 Ibid., p. 84. For good discussions of this concept, see: Prigogine, Ilya and Isabelle Stengers, Order Out of Chaos, New York: Bantam Books, 1984. 5 For good discussions of these issues, see: James Gleick, Chaos, Making a New Science, New York: Viking Penguin, 1987. 6 See for example, Wilber, Ken, The Holographic Paradigm and Other Paradoxes, Boulder: Shambhala Publications, 1982. 7 See for example, David Bohm, Wholeness and the Implicate Order, London: Ark Paperbacks, 1980. 8 Cunningham, A.J., "Information and health in the many levels of man: Toward a more comprehensive theory of health and disease," Advances 3:1, pp. 32-45, 1986. 9 Carl Friedrich von Weizsacker, The Unity of Nature, 1980, quoted from Jahn, R.G. and B.J. Dunne, Margins of Reality, San Diego: Harcourt Brace Jovanovich, 1987, p. 298. 10 For good discussions of these issues in medicine, see: Lawrence Foss and Kenneth Rothenberg, The Second Medical Revolution, Boston: Shambhala Publications, 1987. For more general discussions of the applications and importance of the information theory model, see: Alastair Cunningham, "Information and health in the many levels of man: Toward a more comprehensive theory of health and disease," Advances 3:1, pp. 32-45, 1986. For more technical discussions and descriptions, see: Ernest Schoffeniels, Anti-Chance, New York: Pergammon Press, 1976. 11 For good discussions of these concepts, see Capra, F., The Turning Point, New York: Bantam Books, 1982; and Foss, L. and K. Rothenberg, The Second Medical Revolution. 12 Capra, F., The Turning Point, New York: Bantam Books, 1985, p. 266. In the systems model, what passes back and forth between each interacting system or level is information (see above). Like the use of information theory, systems theory allows descriptions of how a person, for example, interacts with all internal and external systems, i.e., it allows an holistic description of the person.

DESIGNATION

Paradigm Publications is a participant in the Council of Oriental Medical Publishers and supports their effort to encourage explict statement of the methods and sources used to produce Oriental medical texts in English. This text was originally composed in English but reports research performed by the authors and published in Japanese. The clinical and basic research methods employed are documented in the text. The definition of the technical terms used by Dr. Manaka are given in the Glossary. Those not noted in the glossary follow Wiseman, Glossary of

Chinese Medicine and Acupuncture Points.

SECTION ONE: SIGHTING THE DRAGON

~:,.. ~; ~

~\ \

.,fl

;u I~

0

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CHAPTER ONE

ACUPUNCTURE: TRADITION AND TRANSMISSION Acupuncture and moxibustion therapies are believed to have originated in China approximately two thousand years ago. As a traditional medical practice, they encompass several treatment methods. The main method is the use of needles to puncture the skin. Secondarily, moxibustion is used to warm or cauterize points on the skin. Bloodletting, cupping, scratching needle techniques, and fire needle techniques are supplementary methods. The enormous clinical value of acupuncture and moxibustion therapies is evidenced by their continued and extensive use in modern China, their spread centuries ago to other Asian countries, such as Japan, Korea, and Vietnam, and their more recent arrival in the West, where they have weathered even the rigorous scrutiny of Western science and medicine, revealing some of their secrets to scientific method. The tradition of acupuncture and moxibustion is rooted in, and based on, a few ancient medical texts, such as the uan Di ble" Jing SU-. Wen, Huang Di Nci Jing Ling Shu, and Nan Jing ( 'rca 300 BC to 100 AD, texts t at ave formed a ric intel1ectual radition through countless commentaries, developments, extensions, and explanations in numerous subsequent texts.I Throughout this long and venerable history, a complexity of theories and clinical systems have evolved. In some cases these have retained their original form, and in other cases, they have adapted to the passage of time, transforming under the scrutiny of clinicians and scholars.

TRANSMISSION In ancient times people did not have the mechanisms for storage and transmission of knowledge that we have today. Technology was not in the hands of a few specialists, but in the hands of " doers," craftsmen and artisans. These craftsmen and artisans practiced acupuncture and moxibustion and developed high levels of expertise without the formal education that is emphasized today. They amassed experiential knowledge and the know-how of important clinical methods, passing their knowledge on in the classical texts. Using right-brain pattern recognition more than left-brain analytic methods, they constructed sophisticated methods and systems that achieved clinical success without the appearance of the scholarly and coherent methodologies that are so important to us today.

4

Acupuncture: Tradition & Transmission

There are Western scholars who claim that no Western scientific methods were practiced in ancient China, that acupuncture and moxibustion are justified only as folk medicines with traces of shamanism. Methods such as applying simple, naturalistic philosophies, and using theories such as yin-yang and five phases to explain complex medical phenomena, are seen by such Westerners as thoroughly unscientific methodologies, inappropriate for the modern world. Yet the prevalence of this Western intellectual chauvinism is at odds with the facts. Many excellent therapeutic systems were developed in China; many excellent methodologies and technologies, among them the early use of magnets, compasses, gun powder, and astronomical instruments, had their nascence in ancient China.2 At the time of the European Middle Ages, at least twenty influential ideas and technologies had been imported from China to the West, but only two had been exported to China. Something of a paradox can be glimpsed between the historical facts and the claims of some scholars. We would hope that such evidence might encourage us to set aside haste in judging the cultural legacies of others and in adapting them too abruptly to our own cultures. We might discover that taking the theories and language of acupuncture and moxibustion out of clinical context, and solely at face value, is not highly useful. We might discover that without a broader appreciation of the rich background and legacy of these medicines, it is all too easy to misinterpret them. We must at least acknowledge the continued survival and success of these medicines in the modern world.3 Not only has the practice of acupuncture and moxibustion gained acceptance at the professional level, but these traditional therapies have also made considerable gains in the medical delivery system.4 As acupuncture as a medical delivery system is transmitted from its ancient Eastern origins to modern Western cultures, it is essential that we recognize and understand the difficulties inherent in such transmission. For it is only by so doing that we may be able to grasp the nature of acupuncture and moxibustion and develop consistent and powerful clinical methods. By first recognizing these difficulties and then developing strategies to address them, we may find that we are not only able to clarify and verify many of the classical theories, we are - with good research methodology - able to encounter phenomena not yet described and develop new, more comprehensive theories and powerful clinical procedures that are potentially more suitable to the modem world. By raising questions in a framework broader than most other researchers use, and suggesting research methods, we may be able to point the way to a more thoughtful approach to the study of acupuncture and moxibustion.s UNCLEAR TERMINOLOGY

Such a diversity and wealth of literature exist in the native languages of China and Japan that sifting through the traditional ideas and clinical applications requires the skills of scholars as much as the clinical insight of practitioners. Archaic and classical Chinese create particular translational problems that require specialized philological work. The classical texts described people, health, and disease using different terms than those familiar to us today. To compound this obstacle, the general concepts described in these early texts are often rooted in clinical experience and thus do not lend themselves to interpretation by intellectual endeavor alone. Careful coordination and cooperative methods of translation are required. Even given such coordination, perhaps we can never really know what was meant by terms two thousand years old. Perhaps our modem languages and experiences simply do not entertain equivalent concepts.

Acupuncture: Tradition and Transmission

5

Many use the arcane jargon of the old texts without really understanding its meaning. This is particularly true because of the predominance of left-brain thinking and cognition in the modern world, and its broad application to all things. However, we should recognize that the terms of these arcane jargons are often keys that are essential to a deep understanding of acupuncture and moxibustion. They require appropriate and reasonable methods of examination, analysis, and testing, before they can be understood accurately and coherently. One day, as when Champollion deciphered the Rosetta stone, a genius will decipher and explain these key terms. When this happens many will be surprised by the immensity and importance of this cultural legacy. A good example of this conceptual and translational difficulty is the term qi, The Huang Di Nei Jing Su Wen is generally acknowledged to be the primary extant text in the field of acupuncture and moxibustion. Of the more than fifty thousand characters comprising this text, over eleven hundred (about one in fifty characters) are the term qi. It is obvious that this term has considerable significance. According to tradition, everything is composed of qi in one form or another; all movement involves qi. There have been many translations of the term by scholars and practitioners alike, all of which pose difficulties. We commonly find translations such as "vital force," "vital energy," "life force," "energy," "breath," "spirits," "air," "pneuma," "influences," all of which represent some specific aspect of the term, or a generalization of its concept, but rarely both.

#\, in Japanese ki.

In a modern Chinese dictionary, we can see that the term qi is given quite a wide variety of meanings: "gas; air; breath; smell, odor; weather; airs, manner; spirit, morale; to make angry, to get angry; bully, insult; [in Chinese medicine] vital energy, energy of life." Obviously, the term is used in many different senses in everyday language. Characterizing all these different meanings and nuances with a single term or translation is difficult. Qi is expressed in personality and in emotional context. In Japan, we greet people by asking how is their yuan qi: "0 genki desu ka?" As practitioners, we treat people with our qi. Certain techniques of breathing and gymnastics such as qi gong and tai ji build and master the qi. The classical literatures of China and other East Asian countries provide many examples of simple expressions of the universal and encompassing nature of qi: Heaven and Earth have correct qi; its form is flexible and fluid. In the lower parts it is in the rivers and mountains on earth; In the upper parts it is in the sun and stars in the sky; The human being is said to be overwhelmingly and universally soaked in it. - The zheng qi song of the Wen Tian Xiang, before 200 BC. Life is the follower of death and death is the predecessor of life, but who knows their cycles? Man's life is due to the conglomeration of the qi, and when they are dispersed, death occurs. - Zhuang Zhou, in Science and Civilization in China II p.76. In everyday language and context, the term qi in China and Japan has multiple shades of meaning and uses, from classical to modern times. When a child inherits characteristics of his or her parents, this is traditionally said to be the xian tian qi, the "before heaven qi," or "prenatal qi." It is recognized that some form of qi passes from parents to their offspring. In the twentieth century, we understand this as details of the DNA, chromosomes, genes, etc. Likewise, when someone catches a cold or flu, it was traditionally said to be an external pathogen, a xie qi, such as cold, wind, damp, dryness, summerheat, or heat. Today we use theories of bacteria and viruses. In ancient times, and still in the modern literature, these

6

Acupuncture: Tradition & Transmission

and related phenomena all come under the general heading of qi in some adverse form. It is evident that we cannot define clearly the term qi, but, as we will see, it may be possible to suggest an understanding of its nature based on numerous clinical experiences and researches. What is important in our attempts to clarify and understand such terms is the nature and consistency of the research methodology we use. Qi poses particularly complex difficulties because it is essentially a qualitative rather than quantitative concept. It is thus not open to simple quantitative methodology. But what of quantitative terms? Are they more readily resolved? The term cun for example, loosely translated as "body division" or "body inch," is clearly a quantitative term. Yet similar problems arise with this term. According to the traditional literature, the term cun refers to some distance on the body surface that is different in each body area, and different according to each individual. But in the descriptions of each acupoint, the needle depths for insertion are also given in cun. Little or no indication is given as to which length of cun is meant for each point. It appears that there must be some acceptable standard length for this cun. For Westerners and Asians, the actual length of the cun will vary, because, for the most part, Westerners are taller and of larger body build. Should there be one standard for Asians and another for Westerners? Researchers who have tried to answer this and related questions come to quite different answers. The standard distance of one cun in Japan is now 3.3 em, but other estimates vary from 2 em to 3 cm.6 In China, attempts at standardization of the cun have also been made. One study states, for example, that one cun is 22.3 +/- 0.14 mm? These ranges in length are quite different. How do we resolve this problem? Perhaps the relative definition is best, because it depends on the body area and individual differences. But to the scientific mind, this is not a happy solution. A quantifiable standard is much more acceptable. Translation of the "organs," the zang fu, is also particularly difficult. The original terms and their modem English equivalents can be seen in the following table: Zang Organs xin gan pi fei shen xin zhu (xin bao luo)

heart liver spleen lung kidney heart governor I master (pericardium)

FuOrgans

Western Equivalent Organs

xiao chang dan we dachang pang guang san jiao

small intestine gallbladder stomach large intestine bladder triple burner (triple warmer)

Western Equivalent Organs

We all know that the traditional Chinese terms refer only partly to the physical organs and their physiological functions, those described by Western anatomical labeling. The traditional terms also refer to functions not described by Western science. This translational problem is particularly difficult for the xin zhu/xin bao luo, the san jiao, and pi. It is far from clear that there is even a functional equivalent

Acupuncture: Tradition and Transmission

7

for the san jiao in the Western literature. The xin zhu/xin baa Iuo is not always seen as the.~ericardium, as_H has other functions clearly not related to the pericardium. The _Pt. mvolves what m Western terms may be described as pancreatic functions, but 1t 1s commonly seen as the spleen, which has none of the digestive functions of the pi. There are approximate functional equivalents for the other organs, but for these three, it is hard to see such near equivalence. What is the best way to translate these terms? To a Western-trained doctor, rendering the standard anatomical references can be misleading. But the terms must be translated and those seen in the preceding table, which are in common use, can be at best only approximations, carrying with them many cultural biases. Such problems must of necessity be recognized as unresolvable, at least until some creative individual invents a reasonable methodology for comprehensive understanding. INCONSISTENT TERMINOLOGY

A particularly difficult problem with which we must contend when dealing with the literature of acupuncture, and more broadly East Asian or Oriental medicine, is the inconsistent use of the same terms by different authors, in different books, in different periods. Often the same terms are used by different authors at different times to mean different things. This has created great confusion and considerable difficulty for translators. For example, the terms shao yang, tai yang, yang ming, tai yin, shao yin, and jue yin, when found in the classical acupuncture texts (the Su Wen, Ling Shu, Nan Jing), primarily referred to the pairs of arm and leg yang or yin channels, being a sixfold pairing of the twelve channels. In the herbal literature, especially in the Shang Han Lun, the terms referred more to the stages of progression of disease and the degree of penetration into the body of pathogens. In even earlier pre-medical texts, the terms referred to six periods of the year of sixty days each.s These multiple uses have created considerable difficulty and confusion. Other examples abound. For instance, the use of the terms bu (supplementation or tonification) and xie (drainage or dispersion) raise many interesting questions and difficulties. The term bu generally is understood to mean the supplementation or replenishment of vacancies or insufficiencies, where xie means the ridding, draining, or breaking down of repletions or fullnesses. But there are a greater number of ideas about how these goals should be achieved, some of which are obviously unclear. In massage therapy, massaging with the flow of the channel is said to be supplementing, while massaging against the flow of the channel is said to be draining. Yet, if KI-ll- a reflex point for the bladder channel- is sore, applying a light, stroking massage, following the directional flow of the bladder channel down the legs, will eliminate the pressure pain on this point. By stroking in the opposite direction, we can cause the pressure pain to return. Thinking in terms of supplementation or drainage in a case like this might be inappropriate. These same phenomena would occur regardless of whether the pressure pain on KI-ll is a sign of bladder repletion or vacuity. Instead, we need to redefine the terms clearly, or perhaps to not use them at all in this context. The herbal tradition describes the use of supplementation (bu) and drainage (xie), but sometimes with opposite meaning to their use in acupuncture and moxibustion. For instance, earlier this century, the Japanese herbalist Yumoto Kyushin defined pulmonary tuberculosis as a febrile disease and prohibited the use of moxa to treat it- because of the supplementing and warming effects of moxa. Yet,

8

Acupuncture: Tradition & Transmission

famous moxibustionists such as Takeshi Sawada and Bunshi Shiroda took great exception to this idea. They had unusually go?d results treatin? ~ulmonary ~ber­ culosis using only moxa. How do we recone1le these contradictions? Cons1stent research methodologies might help to resolve these difficulties. In the classical texts the following techniques were all seen to be important methods of supplementation and drainage: 1. The use of inhalations and exhalations 2. Needling against or following the flow of the channel. 3. The selection of specific points. 4. The use of finger pressure. 5. The use of slow and quick techniques. 6. The choice of moxa or needles. 7. The depth of insertion of needle. 8. Blowing or not blowing on the burning moxa. Many contradictions and problems can be discovered when using these various techniques. For example, the classic notion of the supplementing point and draining point can be contradicted. In our research, we have found that these points can produce the same effects depending on how we stimulate or influence them. We have devised powerful clinical methods based on their simultaneous use. Another interesting example of textual inconsistencies can be found in the numerous interpretations of radial pulse diagnosis. In the following table, while it can be seen that most texts share a general agreement over the guan or "bar" position and the cun or "inch" position, it is equally evident that the chi or "foot" position of the radial pulse is different in virtually all cases. This poses considerable difficulty in diagnostic consistency and is one reason why numerous other diagnostic techniques have arisen to help confirm, or deny, what is felt in the pulse. If we study the table on the following page, we can see various interpretations of the three positions of the radial pulses on the left (L) and right (R) arms in the superficial (yang) and deep (yin) positions.9 Many interpretations other than these eight can be found, as can different translations of the same passages, but we can clearly see differences in these samples. There are many more examples of confusion or inconsistency in the literature. Some may have stemmed from the widespread use of simple mnemonic rhymes. When they were written, they may have served as useful learning devices for students who were almost always clinical apprentices as well. Today these rhymes are often confusing and difficult to understand, and have contributed to irregular translation. Other unclarities may have arisen through attempts to simplify the literature, especially the introduction of simple formulary approaches. Such approaches were likely invaluable for the study of acupuncture, particularly for beginning students who could thereby obtain reasonable results quickly. However, as diminishing attention was given to the more traditional concepts of restoring balance and harmonizing the whole body (a concept, as we will see, that is essential to the practice of acupuncture), more information became lost. Further, many such formularies were given simplified explanations. Over generations, this approach lead to the creation of treatment strategies based on reduced information; understanding became more difficult.

Acupuncture: Tradition and Transmission

Comparison of radial pulse diagnoses Text

Position

SuWen

cun cun guan guan chi chi

Side R L R L R L

Yang level LU HT 5T diaphragm KI KI

Yin level chest CV-17 5P LR abdomen abdomen

Nanling

cun cun guan guan chi chi

R L R L R L

LI 51 5T GB TB BL

LU HT 5P LR PC KI

Nan ling Ben Yi

cun cun guan guan chi chi

R L R L R L

LI 51 5T GB TB

LU HT 5P LR PC KI/BL

cun cun guan guan chi chi

R L R L L R

LI 51 5T GB (?)TB KI/BL

LU HT 5P LR

Mailing

cun cun guan guan chi chi

R L R L R L

LI 51 5T GB child door/TB/KI/BL left Kl

LU HT 5P LR BL

Mailing Tu Shuo

cun cun guan guan chi chi

R L R L R L

LI 51 5T GB TB BL

LU HT 5P LR

cun cun guan guan chi chi

R L R L R L

-

LI/TB

LU HT 5P LR Original yang/KI/BL Original yin

cun cun guan guan chi chi

R L R L R L

chest CV-17 5T diaphragm/GB LI 51/BL

LU HT 5P LR Kl TB

Qian lin Yao Fang

Lei ling

Yi Zong lin lian

mingmen

PC 5T GB

51/mingmen

??

mingmen KI

9

10

Acupuncture: Tradition & Transmission

EXPERIENTIAL ADAPTATIONS

In both historical and modem times, the practice of acupuncture has involved employment of differing treatment levels or differing treatment targets. Some focus only on the patient's symptoms and apply needles with the intention of alleviating or ameliorating those symptoms. (A common form of this therapy is shi?~­ ki ryoho or stimulation therapy.) Others focus on the state of the flow of the qt m the meridians or channels, and apply needles to correct the flow of qi. (A common form of this therapy is keiraku chiryo or channel therapy.) Still others adopt some middle ground between these two and combine both aspects in treatment. Significant variations in approach and teaching methods are the result of these different focuses. As a result, studying acupuncture and moxibustion can be difficult and confusing for the beginner. Recognizing this, many translations, schools, and traditions within the field of acupuncture and moxibustion simplified the techniques for study and for teaching so that the student might learn more easily. (A good example of this process is the barefoot doctor training in China.) These simplifications tried to reduce and rationalize major parts of the field into a· single coherent system. Though helpful at face value, over time many useful concepts were ignored or simplified to the point of inaccuracy. This is clearly seen in the T.C.M. system most popular today, the bagang bianzheng, where essential components of channel theory, as well as structural, five-phase, and biorhythmic concepts are ignored or simplified to mere aphorisms. It is fine to do this; within the delivery system established in China it is effective and useful. For the beginner, or those whose place in the system will be essentially paramedical, the approach is satisfactory. Yet when examined in detail this system creates basic problems. For example, the popular notion that an acupoint has specific, defined effects, a key concept in this system, disintegrates quickly when we raise the question as to how specific effects were defined and what tests determined their validity. We must also address the fact that the functions of acupoints can vary from patient to patient. Changes occur in the points based on daily biorhythms, biological changes, changes following infection,lO surgery, etc. If we ask what points are good for asthma we may be able to list a few that will produce a 50-60% success rate with asthmatic patients. But what of the other 40-50%? These same acupoints do not have the same characteristics. This may be an easy way for students to study acupuncture and moxibustion, but in a clinical setting it rapidly becomes limiting and overly complicated. When there are many points said to be good for a given condition, how do we select the ones to use? What parameters are used in the decision process? The more parameters, the more complex and difficult the decision becomes. Yet, the more simplistic the criteria, the lower the rate of treatment success. The clinician with many years experience can decide with ease which points to use, but how does the beginner decide? Many years ago I treated a patient who had a twenty-year history of asthma. I treated her asthma by burning moxa at CV-22 (at the center of the jugular fossa). This completely eliminated her symptoms. It was more than twenty years before I heard from this patient again. She was only beginning to experience a return of her asthma; apparently, that single treatment had eliminated her chronic asthma completely! Because of this experience should I conclude that burning moxa on CV-22 is effective for asthma? Likewise, many years ago I was treating a difficult and stubborn case of trigeminal neuralgia. Various forms of therapy had so far been helpful, but only with short-lived success. Since I was researching and studying the eight extraordinary vessels at the time, I decided to try the extraordinary vessel confluence-jiaohui

Acupuncture: Tradition and Transmission

11

points, SI-3 and BL-62, with TB-5 and GB-41, using silver and gold needles shallowly inserted on the side of the body opposite to the pain. This completely eliminated the pain! Should I then have concluded that this was the treatment of choice for trigeminal neuralgia? The interesting questions about these case studies are more to do with methodology. The problems exist at three basic levels. First, at what level of use and experience should an observed clinical effect be incorporated into the body of clinical literature? That is, at what point can we say that moxa at CV-22 is good for asthma, or that gold and silver needles at the yang wei mai and yang qiao mai effectively treat trigeminal neuralgia? Second, how are such effects differentiated within the corpus of clinical literature and when is it acceptable for such observations to submit to experiential adaptation? That is, how do we determine when and how to use these treatments? Third, who is qualified to make such decisions and what is th~ appropriate methodology for making them? This last question is bound to be culturally and historically dependent. The way such findings may be interpreted in modem China or modem Japan will be quite different, depending on the theoretical perspectives of the interpreter. Let us imagine that it is nearly four hundred years ago in China and I am a good friend of Yang Ji-Zhou, the author of the Zhen Jiu Da Cheng. Because of this, he might have included these treatments in his text of 1601, despite the limited experience of my two cases. Today, almost four hundred years later, practitioners and students reading his text will place enormous trust in my results because they were included in this great and revered text, and because my friend's reputation in later centuries is excellent. Is this a sufficient criteria for making general proclamations about the treatment of asthma and trigeminal neuralgia? What if these treatments were to go through the mill of heuristic adaptation and later authors transmitted my results by saying only that CV-22 is good for asthma, or TB-5 is good for trigeminal neuralgia, without including the method I used (moxa) or the theory of the extraordinary vessels? What if translators then simplified the terms with which I diagnosed these conditions? Would these points reliably produce the desired results or would there be only a statistical percentage of patients who were helped? These are particularly difficult questions because methodology is something remarkably lacking in traditional literature. Simplifying the accretion of therapeutic effects observed over the centuries into a list of functions is useful for the beginner. But who sifted through the literature? What standards and models did they apply to interpret it? What assumptions did the compilers and translators bring to their work? We have no simple answers to these questions, but we have at least tried to address them by devising methodologies appropriate to the ideas. Because of the great diversity of information that has developed over the centuries, we have found that generally it is better to have a more flexible model and method. Even within the lifetime of a single practitioner, many changes of theory and practice can occur. Imagine how much more complex this is with thousands of practitioners. In modem practice we often see such changes; a particular practitioner may develop a specific methodology that yields a model changing over time. Dr. Paul Nogier, the founder of auriculotherapy, first defined very specific points and areas in the ear with specific point recipes for each disease. But now, after many years of practice, he has found that there are three overlaying maps which may be active simultaneously.ll He has a rather complex method for using these findings, but for the beginner and general clinician he simply recommends

12

Acupuncture: Tradition & Transmission

auriculotherapy using pressure pain points in the ears. This initial approach is easy for the student to learn because of a clear methodology and systematization. However, as the clinical findings and theories become more complex, they are more difficult for the beginning student to grasp. The second approach, the approach of auriculomedicine, is difficult for the student to learn, and is perhaps only really comprehensible to clinicians, as it is more experiential and less intellectual. As clinical practitioners develop more expertise, their techniques and strategies often evolve, leading to quite different approaches. This is necessary for both individual and general growth, but is typically not within the grasp of students. Hence students are generally exposed to a systematized approach that tries to sidestep these issues. But, just as in a game of chess or in a fencing match, the players must modify their techniques based on their opponent's reaction, in medicine, the practitioner must do the same based on the response of the patient. Often the simplified systematic approaches that beginners learn are not sufficiently flexible to allow for such modifications. What is important is the need for, and utilization of, a creative and consistent research methodology and methods of assessing the effects of treatment. We can take nothing at face value because without clinical tests and confirmation, we have no real idea of what these simplifications mean. RESEARCH DIFFICULTIES

In recent years much scientific research has been done on the nature and mechanisms of acupuncture and moxibustion. While this is laudable, it often leaves unanswered questions as to what the classical acupuncturists were doing. A major focus of this research has been the neurological effects of acupuncture, but this is really only one part of what happens during therapy. The effects of treatment are complex and entwined. Some are hidden and hard to measure. Yet as we hope to demonstrate, these minute signals and responses are probably the most important occurrences and the ones most closely allied to classical theory and practice. Many scientific researchers in acupuncture tend to take a narrow perspective in their research, unfortunately neglecting the larger picture and losing sight of the general significance and effects of acupuncture. Such a perspective also creates poor clinical research and practice. This was evidenced in a recent symposium of the Society of Japanese Acupuncturists and Moxibustionists on the systematization of the diagnosis and treatment of lumbar problems. Instead of looking systemically at lumbar problems, it focused only on the diagnosis and treatment of the lumbar region. While this may be a good "scientific" approach, this simplistic, reductionist approach can only fail to achieve a complete understanding. This method ignores the simple clinical reality that we are frequently able to treat lumbar problems without touching the lumbar region. Unfortunately, modem scientific researchers and acupuncturists scorn traditional theories (channel theory, five-phase theory, etc.). This may be simply the result of their inability to devise suitable tests or to develop equipment sensitive enough to research these theories. Whatever their reasons, this mental bias in their approach biases their results. Scientific research is further hampered by its own unattainable concept of rigor. The double blind study is the supposed pinnacle of clinical research, yet in acupuncture research, it is impossible to perform a true double blind study. Some of the effects involved in acupuncture and moxibustion are so subtle that they are impossible to block or eliminate. These effects are more than the placebo effect,

Acupuncture: Tradition and Transmission

13

which is a thorn in the side of any medical researcher. They manifest at more subtle levels, such as the simple touch of the patient by the therapist. We can show how touch can have a series of effects, two clearly demonstrable ones being the touch of the thumb versus the touch of the little finger. Both these techniques produce notably different effects depending on where the touch occurs. Even the best designed double blind studies involve touching the subject in some manner, if only to insert the needles. How are we to account for the potential effects of touching contact? Further, in certain styles of acupuncture practice, the success of treatment depends in part on the practitioner's qi for its efficacy. How can these effects be eliminated and leave a viable form of treatment to be studied? Another related problem in the scientific analysis of acupuncture arises at a more basic level. The premises that comprise the foundations of acupuncture and East Asian medicine are quite different from the premises that support Western science and medicine. As a consequence, applying Western premises to the analysis of acupuncture and East Asian medicine may, at times, be like trying to slice a loaf of bread with a chain saw: it is possible, but very little of the bread remains. The following passage from the Tang dynasty medical sage, Sun Si-Mo, expresses some of these differences: There are diseases whose interiors are the same, but whose exteriors are different, and vice versa. Therefore the repletion and vacuity of the zang and fu, the smoothness and blockages of the blood vessels, ying, and wei cannot be observed [solely] by the ears and eyes, [instead they] can be elucidated by pulse diagnosis. There are floating, sinking, wiry, and tight [categories] of pulse in the blood vessels. There are high, low, shallow, and deep flows in the different inductive [acu]points. There are differences in the thickness, thinness, hardness, and softness of the skin, muscles, and bones. Only a person who uses his heart [/mind] delicately can tell these differences.12

Western medical analysis needs objective signs and indications before diagnosis and treatment are determined. Here, traditional Chinese medicine is seen as relying primarily on subjective assessments, in particular, intuitive observations and decisions. This is a significant difference between Western methodology and Chinese or Japanese traditional medical methodology. While scientific research is important for mapping some of the effects of therapy, it rarely addresses the important questions regarding what it was that the classical texts tried to describe. It is self-limiting in a field such as acupuncture, where it is impossible to rule out or describe the subtle effects - which are possibly the more important effects - and is thus not very helpful in achieving the goal of a consistent research methodology. This does not, however, rule out the use of scientific knowledge and technology for achieving this goal. The current attitudes toward the research and the teaching of acupuncture and East Asian medicine in Japan arose during the Meiji era. The government was desperately and hastily trying to modernize Japan. The medical systems of that time, including acupuncture, moxibustion, anma (massage), and herbal medicine were Westernized, both in their theoretical descriptions and the manner in which they were allowed to be taught. The traditional theories were completely thrown out, and, with the exception of the blind practitioners of acupuncture, moxibustion, and anma, who were allowed to continue as part of the government's social policy towards the blind, all other practitioners were banned from practice. The Ministry of Education set the curriculum for the education of the blind. The committee that decided this curriculum submitted the following plan:

14

Acupuncture: Tradition & Transmission

Since the channel is a concept not considered by Western mediciJ!e, it shall be omitted and instead of talking about the jing xue, channel acupomts, the term kong xue, acuholes, will be used. The kong xue will be taught solely by their anatomical locations and their effects [main indications]. Treatments for particular diseases will be given simply by listing combinations of kong xue for each disease.

The principles in this plan still seem to be in operation in most schools of acupuncture in Japan. The scientific study of acupuncture typically takes these Meiji-era modernizations as fundamental to research protocols. As a consequence, most research ignores the basic principles and premises of acupuncture. This problem is not limited to Japan. Also in China, for example, following the political changes of the late 1940's and the cultural revolution of the 1960's, acceptable methodology for the study of acupuncture underwent enormous revision. Political, social, and cultural influences play important roles in the determination of methodology and protocol. Modem politics usually has had little patience for the ancient and traditional theories of China. If we are truly to appreciate and understand acupuncture and moxibustion, we must take an open-minded approach. We must contend with the difficulties of transmission of knowledge posed by the differences of culture and language, and acknowledge that much of the information described has been derived from clinical experience and thus may not be amenable to a strict Western analytical, academic method. Who in the modem world, where scientists are making fundamental discoveries so rapidly that they need constantly to redefine principles, would want to state that a particular body of "scientific knowledge" and the methodologies on which it is based, represents a fixed, immutable constant of universal application? If the standards and methodologies of traditional Western science are inappropriate for modem Western medicine, how much more is this true for East Asian medicine?l3

TOWARDS A MEDICAL EVOLUTION The interaction and evolution of different medical systems is a phenomenon dependent on many factors. Paul Unschuld describes the integration of East Asian and Western medicines in three stages: coexistence, cooperation, and integration. These stages appear on three fronts: the methods or means, the personnel, and the systems used. The progression through these three stages is already underway, particularly in China where East Asian and Western medical systems have evolved through coexistence and cooperation toward an integrated approach. But, in general, the evolution of personnel and systems will take more time. In China, personnel coexist and are beginning to cooperate, but have not come close to an integrated approach. The systems, however, are neither cooperating nor integrating, merely coexisting. This is a complex issue; there are many methodological considerations that must be resolved before further evolution can occur. It is our hope that the theories, methods, and clinical procedures that we have developed and that we present here will point the direction for others to follow. Perhaps the models we describe in this text will help this evolution through cooperation and integration of the medical systems. To be honest and fair to these theories and clinical medicines, we should approach them with unbiased minds; we should not prejudge based on current standards. Throughout the long history of acupuncture and moxibustion many

Acupuncture: Tradition and Transmission

15

geniuses devised and described powerful theoretical models and clinical techniques. Some of these have survived to modem times, but many have sunk into obscurity to await rediscovery. We should never dismiss something because we are unable to understand it, or because it does not fit clearly into our current model of how things are. As clinicians, researchers, or scholars, we can only make progress in unravelling the Rosetta stone of East Asian medicine with open minds and willingness to participate in this research adventure. It is our purpose in this book to give examples of how one can begin to approach the Rosetta stone, to hold up a beacon to light the way. Throughout the theoretical sections we will discuss classical theories, raise questions as to their meanings, and describe clinical research methods by which these theories can be confirmed and described. We think that the research methods and clinical tests we have devised and the good clinical results we have obtained will justify our theoretical conclusions. But, probably more than anyone, we recognize the inherent limitations and possible contradictions of all these ideas. It is in this light that we would like to clarify our purposes and methods with a simple yet profound saying that arose in the tradition of the tea ceremony and has continued as a traditional teaching method: In Japanese, -;r li8i ~ is termed shu ha ri; in Chinese, it is termed shou po li. Simply put, this means what we absorb and obey, we must eventually break away from (so as to begin our own new tradition). To merely follow our teacher's tradition is not sufficient, but it is a necessary starting point. If we take the wisdom of shu ha ri, we can develop a suitably flexible mind and approach, and begin to make real progress.

CHAPTER ENDNOTES 1 Paul Unschuld lists more than 130 commentaries in Chinese and Japanese on the Nan Jing alone. See: Medicine in China: Nan Ching, the Classic of Difficult Issues, 653-669. 2 Joseph Needham's multi-volume work, Science and Civilization in China, gives an exhaustive and enlightening recital of such discoveries. See especially volumes III, IV and V. 3 In Japan, for example, acupuncture, moxibustion, and herbal medicine have attained a level of clinical success that compares well with Western medicine. These therapies are often found integrated with allopathy. Research is often government-sponsored and conducted at prestigious universities and medical schools. In China in the last twenty years, considerable government-sponsored research has been conducted. In France, acupuncture training is conducted as a post-graduate specialization for medical doctors. Numerous other countries use and recognize acupuncture and moxibustion to varying degrees. 4 In Japan, for instance, such therapy is favorably viewed by the populace. In a study conducted from 1975 to 1976 by researchers at the Chiba University Oriental Medicine Research Association, the researchers found that acupuncture, moxibustion, and herbal medicine were favorably judged by those who participated in the study. Questionnaires were sent to more than 2200 patients who came for therapy. With nearly half responding, the statistics clearly showed that most patients had tried Western medical therapy (75%) before coming for acupuncture, moxibustion, or herbal therapy. Most gained improvement or abatement of their symptoms (approximately 70%) following therapy using one of these three methods. Most patients reported that they would use or recommend these therapies in the future (approximately 60%) and most felt that both modem (Western) and traditional (East Asian) medical systems were necessary (80%). Clearly, in Japan, the existence of diverse medical systems is seen as favorable and complementary. 5 S.B.: Some serious attempts have been made to broach the problems of translation and transmission. Among the best descriptions are in the work of Nigel Wiseman. His introduction to Glossary of Chinese Medical Terms is a thorough analysis of the topic, and the work itself is notable for the inclusion of Asian clinicians in the process of term selection and definition. 6 For instance, Dr. Yoshio Nagahama defined one cun as three centimeters (see Shinkyu Chiryo no Shinkenkyu p. 21). Dr. Haruto Kinoshita defines it as two centimeters (see Illustration of Acupoints p. 12). 7 Chen Weichang et al., "The determination of the depth of puncture for the development of needling sensation," National Symposia of Acupuncture and Moxibustion and Acupuncture Anesthesia, June 1-5, 1979, pp. 113-114.

16

Acupuncture: Tradition & Transmission

8 This is also seen in the medical literature. See for example, Nan Jing 7 (Paul Unschuld, Medicine in China: Nan Ching, the Classic of Difficult Issues, p. 122). 9 From Y. Manaka, Ilea no Tameno Shinjutsu Nyumon Kuoza p. 135, Yokosuka: Ido no Nippon Sha 1958, 3rd edition. The books referenced come from the following approximate dates: Su Wen, 300 BC; Nan Jing, 100 BC- 100 AD; Nan Jing Ben Yi, 1361 AD; Qian fin Yao Fang, 652 AD; Mai Jing, 300 AD; Mai Jing Tu Shuo, circa 290 AD; Lei Jing, 1624 AD; Yi Zong fin Jian, 1742 AD. For a more complete discussion of the interpretation of the six pulse positions, see Birch, S., "An historical study of radial pulse six position diagnosis: Naming the unnameable," Journal of the Acupuncture Society of New York 1:324, 19-32, 1994. 10 As is evidenced in trigger points; see: Travel J. and S.H. Rinzler, "The myofascial genesis of pain," Postgrad. Med. 11 (1952), p. 425-434. See also, Melzack, R. et ai.,"Trigger points and acupuncture points for pain; correlations and implications," Pain 3:3-23 (1977). 11 P. Nogier, From Auriculotherapy to Auriculomedicine, Saint-Ruffine: Maisonneuve, 1983. 12 Y. Manaka, quoting from the Qian fin Yao Fang in "The treatment of several diseases of the neck, shoulders, and arms by acupuncture and moxibustion," Modern Oriental Medicine 3:4, 1982. 13 S.B.: There have been many publications on the problems of research methodologies in Western medicine, a number of which are referenced in the introduction.

CHAPTER

Two

THE X-SIGNAL SYSTEM

What cannot be seen is called evanescent; What cannot be heard is called rarified; What cannot be touched is called minute. These three cannot be fathomed And so they are confused and looked upon as one. Its upper part is not dazzling; Its lower part is not obscure. Dimly visible, it cannot be named And returns to that which is without substance. This is called the shape that has no shape, The image that is without substance. This is called indistinct and shadowy. Go up to it and you will not see its head; Follow behind it and you will not see its rear. -D.C. Lau, tr, Lao Tzu: Tao Te Ching XIV:70.

In a way, the whole idea of the tao was the idea of a field offorce. All things oriented themselves according to it without having to be instructed to do so, and without the application of mechanical compulsion.

- J. Needham, Science and Civilization in China II:293. Most living systems exhibit multilevel patterns of organization characterized by many intricate and nonlinear pathways along which signals of information and transaction propagate between all levels, ascending as well as descending. - Fritjof Capra, The Turning Point, p.282.

In our years of practice and research, we have unravelled many stories. In so doing we have found a story of our own that draws on both classical Chinese theories and modem scientific research. This fusion we have named the "X-signal system." We think that this is an apt name because what we are describing is something hidden, virtually unknown, but something essential to the practice of acupuncture and moxibustion. We can only paint a picture in broad brush strokes, leaving the work of filling in the details to others. This, too, is one of the goals of this book, to stimulate more good clinical research.

18

The X-Signal System

From this research, and from the perspective of the signal system, we have developed a systematic and comprehensive treatment plan with many alternative treatment methods. In our presentation of this material, we hope that you will be able, by example, to devise your own treatment style. We feel that this is important, not only for your own growth and development, but for the continued growth of acupuncture and moxibustion. If we appear at any time to be making fixed and absolute statements, you are well advised to review the text. When I begin to lecture an audience, regardless of who they are, I often begin by saying, "Don't believe what I'm going to tell you." It is our purpose only to show by example how you, the reader, can mold your own practice and perform your own clinical tests and research.

As we present the X-signal system at its current state of evolution, we will explain how we see it as related to various theories and practices of acupuncture and moxibustion. We will elaborate some classical theories and the tests, researches, and methods of verification that we have developed and implemented to explicate them. These theories include channel theory; the unidirectionality of channel flow; the closed circuits of the channel flow; yin-yang theory and its relationship to body structure, topology, and thus the extraordinary vessels through octahedral theory; the five-phase theory and its relationships to isophasality as a branch of topology, and the five-phase engendering ("creative") and restraining ("destructive") cycles. Our simple, demonstrable tests that confirm these theories also use simple statistical research methods such as the meridian imbalance diagram (M.I.D.),l and simple technological tools that influence the body without stimulating the nervous system. Tools including various polarity agents such as the thumb and little finger, the north and south magnetic poles, the positive and negative polarities of different metals, and the ion-pumping cords, have been particularly useful for mapping characteristics of the X-signal system. We believe these characteristics lie at the heart of the classical theories.

THE THEORY OF THE X-SIGNAL SYSTEM The theory of the X-signal system as the biological system that lies at the heart of acupuncture and moxibustion theory and practice can be stated as follows: There is a primitive signal (information) system in the body that has embryological roots, but is masked by the more advanced and complex control (regulation) systems. Thus, the original signal system is hard to find or see. This primitive system is able to detect and discriminate internal and external changes and plays a role in regulating the body by transmitting this information. This system serves as the modus operandi of acupuncture. We have been able to make the following observations about the X-signal systern: - We cannot explain it with neurophysiology because it manifests and is manipulated clinically with minute stimuli or influences that cannot be clearly said to affect the nervous system. - The agents of therapy and their biological actions cannot be explained by current neurophysiology. - As part of the signal system, the vertical relationships - the channel systems - can be used very successfully.

The X-Signal System

19

- It manifests in and through certain acupoints that are topologically related, structurally, functionally, and biorhythmically.

- The octahedral theory, as a general theory of the relationships between structure and function, is an essential component of the signal system. - It appears to fit well with and provide a model of explanation for many classical acupuncture theories and concepts.

- Holographic principles appear to play some part in the signal system. We feel that this signal system is a biological system as yet undiscovered by biologists and anatomists. This is why we have called it the X-signal system. The nature of the signals transmitted throughout the body, the nature of the information flow, is not yet clearly defined. It appears to operate at a more primitive and deeper level than many of the flows of biological information- neural, hormonal, biochemical - that have been clearly defined by modem science. Many parts of this system can be described generally and rationalized using general information theory and the abstract mathematics of geometry and topology. Since it does not manifest through commonly known biological laws, its biological effects and significance need to be carefully distinguished from the known effects of the anatomophysiological systems. This is particularly important because many of the biological effects of acupuncture and moxibustion are the result of direct stimulation of the anatomophysiological systems, especially the neurological system, which tends to mask the effects of the signal system. Having recognized this, we have devised many clinical experiments and invented many clinically useful polarity agents, such as the ion-pumping cords, the ion beam device, and the electrostatic adsorbers. These devices provide minute stimuli or influences so that only the signal system is stimulated. Insertion of needles with stimulation activates both the signal system and the anatomophysiological system, with an array of physiological responses. The clinical rules of the five phases, for example, are difficult to explain by anatomophysiology, as are ideas that materialize the qi and the channels. But, when taking advantage of the signal system, we can see the operation of these rules clearly. With careful examination and use of the correct devices, we have been able to isolate and map specific characteristics of the signal system. As well, we have found that there are great therapeutic benefits to be gained by deliberately influencing the signal system. Mention here of the concept of appropriate scale is pertinent. To look at a particular phenomenon, we must use glasses that are suited to the scale of the phenomenon. If we want to examine the general anatomical structure of an organ, we can examine it with the naked eye. If we want to understand the cellular structure, we must use a microscope. If we want to understand the molecular structure of each cell, we must use the scanning electron microscope or an equivalent scanning instrument. Without appropriate modelling and tools for each scale, we can determine nothing about the phenomenon studied. This is as true in the study of acupuncture as in anything else. If the nature of what we are dealing with in acupuncture is very subtle and, to most people, unobservable and imperceptible to the naked eye, we must devise appropriate methods and tools of observation coupled with appropriate models. The appearance of the dragon we are chasing is elusive. It is so well masked by the clouds of rationalism and dogmatism that we can only glimpse it at specific times in specific conditions.

20

The X-Signal System

BIOLOGICAL EXAMPLES OF THE SIGNAL SYSTEM The Acrasiales amoeba is a slime mold inhabiting the Wand woodlands and forests. Under normal conditions, it is a single-celled organism that lives an independent existence. Yet, when unfavorable conditions arise, the single-celled organisms aggregate to form a multi-celled organism. This larger organism forms a stem and spores, which are released into the environment, where on contact with a favorable medium, they grow and live independently again. This phenomenon is an unusual biological cycle. In spite of the fact that the organism does not have the anatomophysiological systems of higher organisms such as the nervous and hormonal systems, it is able to perform this complex multicellular function. Obviously it has a signal system, parts of which have been recently mapped, but we still do not have a clear understanding of its operation. Even harder to understand is the mechanism of insect communication, as it seemingly violates the laws of chemistry. It has the added difficulty of minuteness of scale. For example, the pheromone, which is a kind of sex hormone, is secreted in very small amounts by females to attract male partners. It has been shown to have powerful effects over relatively huge distances. The concentration of the pheromone in the air must be beyond Avogadro's number, since known amounts of pheromone that are released into the air at a fixed site are able to attract males over sizable distances. Based on simple calculations we must conclude that the pheromone molecule is having an effect at a dilution that leaves no original molecule of the pheromone present. This is a well-documented phenomenon that has even found commercial application in insect control, but has as yet defied rational explanation. It is not yet known how a substance can have an effect in the absence of molecules of that substance. This phenomenon is also seen in the field of homeopathy, where commercial and medical applications have been used for more than a century. Homeopathy is a form of therapy where small amounts of very dilute solutions are taken as medicine. Preparation involves soaking the chosen object (plant, mineral, etc.) in pure water and then adding one part of this solute to nine parts alcohol. This is mixed and then diluted in water to a 1 in 10 concentration, called "01'" This is then diluted, again to a one in ten concentration of the 01 solute, now called "02." This process of dilution continues to a "010" dilution. At each stage of dilution the solution is vigorously shaken. At stage 010, the solution is ready for use, being one of low potentization. With a continued dilution to 030 (a relatively highly potentized dilution), there are no molecules of the original substance left in the solution, since the dilution has passed Avogadro's number. In a single mole of a substance there are roughly 6 x 1026 molecules of that substance present (1026 = 100,000,000,000,000,000,000,000,000.) Very potentized dilutions can go as far as 0100. At these levels of dilution there can be no probability that any molecule of the original substance is present. When solutions such as these are used, they defy the rational understanding of chemistry and pharmacology. Yet the therapeutic effects of homeopathy are too well known to dismiss.2 Experimenters in Russia and Scotland have shown that solutions diluted beyond Avogadro's number do have effects that can be measured. In 1933 in St. Petersburg, Perusson examined the effects of solutions diluted to 10-120. He examined the effects of a super-diluted solution of mercuric chloride on the action of the salivary enzyme ptyalin, which converts starch to sugar. Even at a dilution of 10-120 the mercuric chloride solution was able to affect the rate of starch to sugar conversion.3

The X-Signal System

21

From 1946-1952, William Boyd of Edinburgh performed thorough experiments to verify Perusson's findings. His research seems to be quite legitimate. He used solutions of mercuric chloride at a concentration of I0-61 and found that this dilution of solute was also able to affect the rate of starch to sugar conversion.4 These results raise fundamental questions about our assumptions and presumptions in chemistry and biochemistry.s More recently, researchers in France caused quite a stir when they published the results of a study that showed similar superdiluted effects (antiserum diluted to I0-120). Attempts were made to disprove this recent study; at best, the skeptics have been able claim only that there must be an unknown error. 6 Some modern homeopathic researchers have speculated that the original molecules of the substance, prior to dilution, actually imprint or stencil themselves permanently into the original solute, spatially rearranging the molecules in some way. After many dilutions, this original stenciling survives, even though molecules of the original substance are not present. This stenciling is as yet unproven. How does it work? Is it something electrical? No one clearly knows. The authors of the recent antiserum study in France speculated that "transmission of the information depended on vigorous agitation, possibly inducing a submolecular organization of water or closely related liquids ... Water could act as a template for the molecule, for example by an infinite hydrogen-bonded network, or electric and magnetic fields."7 A similar, perhaps stranger, phenomenon was recently observed by Yasumasa Katsumata, a Japanese physicist and acupuncturist. He has found that any substance that has occupied a certain space will leave some of its properties in that space after the substance has been removed. He has called this sayoshi, "phantom function."8 Mr. Katsumata suggested that the phenomenon is related to the rotation of the earth towards the west, and the rotational gravitational vector. This phenomenon can be seen in other instances and defies clear explanation or refutation. That the body responds to super-dilute solutions of a substance and to phantom functions, suggests that there are systems at work other than the anatomophysiological systems with which science is familiar. We believe that these phenomena occur at the signal level. There are numerous examples of such phenomena in nature, as our daily experiences can confirm. At a wine-tasting competition, a skilled wine taster can sip a small amount of wine and distinguish, from among the minute amounts of hundreds of different chemicals present in the sample, which wine it is and even where the grape was grown and where the wine was bottled. Here, a refined development of the olfactory and gustatory senses can discriminate unbelievably tiny differences. This is difficult to explain with neurological principles, it is too complex and the discriminations are made too quickly. Surely there must be other mechanisms at work! A professional baseball player can hit a ball accurately when it is travelling so fast that it exceeds the reaction time of the nervous system. How is this possible? We can speculate that the strength of the stimulation, the amount of energy (signal) necessary to produce the desired effects, is dependent on the total field in which the energy is received/perceived. At night a car headlight can be blinding, but at midday, it may even be difficult to see. The pheromone released in a field can have profound effects, but if many similar chemicals are released at once, are the effects as strong? Not only do these low-level effects need to be carefully observed, but they also need to be carefully discriminated from the myriad of other effects that

22

The X-Signal System

may be happening simultaneously. As we will see, this becomes significant when we try to examine the effects of certain stimuli on the body. If the n~rvous system is also stimulated, we cannot recognize the effects of the low-level stimulus. The structure, symmetry, and asymmetry of the body may also demonstrably participate in the signal system. For example, in experiments with limb b~d tr~ns­ plantation in salamanders, it is possible, if the bud is transplanted at the nght hme in the right place, to cause a symmetrically opposing bud to form spontaneously, balancing the asymmetry of the transplantation. The salamander, a relatively primitive organism, can be said to have a latent tendency to keep its symmetry.

Figure 2.1: Symmetrical limb bud growth in salamanders

Likewise in the fiddler crab, which has one large claw and one small claw; if the large claw is removed, the small claw will develop to become the large claw and the severed stump will grow a small claw.

Figure 2.2: Asymmetric claw regrowth in the fiddler crab

There is an original asymmetry in this crab that is naturally restored if it is disrupted. In this case, regrowth of the claws is an example of regeneration. Regeneration tends to be limited to certain structures in lower order animals. For instance, a frog or salamander can regenerate a severed limb, while a lizard can regenerate a severed tail. But in higher organisms, where the biological systems are more complex, this form of regeneration does not usually occur except in limited cases, in very specific conditions, with specific stimuli applied.9 We can generalize that the ability to restore normal structure, to return to an original symmetry or asymmetry, is higher in lower-order organisms but decreases as we ascend the evolutionary scale. In biological organisms, this can be seen at the level of organismic allocation of energy to different functions in the body. Specializations that benefit the organism in some respects- greater mobility, greater adaptabilityrequire the sacrifice of other functions - decreased regenerative abilities. Great gains in one area are often offset by losses in other areas. What are the mechanisms and signals responsible for these growths? The latent tendencies towards symmetry in the salamander and asymmetry in the crab are clear but not explicable. In these cases we can say that the signal system is responsible for the phenomena observed, but this too needs further clarification.

The X-Signal System

23

ORIGINS OF THE SIGNAL SYSTEM Professor Ernest Schoffeniels of the University of Liege has helped considerably to develop the use of information theory in biology, particularly with his discussions of "generalizing information theory to open systems." His book L'anti Hasard (Anti-chance) is particularly interesting and useful. He applies thermodynamic theory and information theory to the process of biological evolution, and in so doing casts new light on the nature of biological systems. In a 1984 lecture in Tokyo he summarized his conclusions thus: In recognizing that biological systems are cybernetic networks, the conclusion is reached that there are two main languages in biology: molecular and electrical. Since a molecule can be an information, operations befalling it in a metabolic sequence are informational and enzyme catalysis is the executor of these operations. The problem of information transmission can now be introduced: generator of information, encoder of information, information channel, receptor of information. Additionally, one has to define the properties of the transducer whose effect is to transform one language into another thus allowing for tuning of the generator and receptor. Two fundamental problems only partially answered are those of conservation and combination of biological information. Application of classical information theory to the calculation of the information content of biological systems is beset with contradictions. To understand the cause of these setbacks, it is useful to review the most important points of information theory, establishing relations so derived with classical thermodynamics. Then one must consider the problem from the angle of information accumulation in the course of time within the DNA, a true integration of different information received by biological structures and therefore, derived from Prigogine' s and Eigen 's theories, to consider the evolution of biological structures in relation to a changing environment. This leads to a deterministic mechanism of evolution. Thus it is on the background of genetic information that systems develop which allow interaction of an informational nature with the environment. Herein lies the importance of the generalization, epitomized in the feedback organism-environment, that in an evolving environment, an organism can only evolve.

His theories are quite complex and very powerful. What is of importance to us here is his idea that the DNA, the biochemical memory of the cell, contains enfolded layers of information that are derived from the most primitive of organisms at the earliest stages of evolution. Much of this information is biochemical, some may be structural. It is well known that the structures of biological molecules can encode information beyond the atomic sequencing of the molecules. With the right influence, stimulus, or circumstance, this stored information can be made to manifest as a particular sequence of events or actions even in more advanced organisms. Thus, it may be that just as the salamander and fiddler crab have stored in their genetic memory a certain tendency towards symmetry or asymmetry, the slime mold has the information required to cause its pluricellular state to arise and govern its return to the unicellular state. With the right stimulus this information is released from within the layers of DNA so that the resulting activities and changes ensue. While we agree in principle with Schoffeniels' thesis, we should add that the complexity and diversity of bioinformational effects make it unlikely that DNA is the sole repository of this information. There are probably other systems capable of storing biological information. We can observe the natural order of each event that occurs and measure the phenomena at each stage. There is an unobservable higher order of organization

24

The X-Signal System

that governs these activities and changes. This can come from organismic and even global levels of organization. If, for example, the Gaia hypothesis is correct, all living organisms would be functional parts of a larger organism.lO In this case the higher order of organization would be literally global and hidden levels of functional organization would exist everywhere around us. The ability to see this higher order is entirely dependent on the scope of the method we choose to search for it. Mathematicians, physicists, astronomers, meteorologists, and researchers in many disciplines have begun to uncover even more general, and probably universal, higher orders in nature. There are organizing principles and levels of organization that appear only when the correct method of analysis, commonly computer-enhanced mathematical analysis, is used. For example, one astronomer discovered that simple geometric organizing principles were capable of explaining complex, apparently random, celestial orbits. The key, he believed, was the repeated stretching and folding of phase space in the manner of a pastry chef who rolls the dough, folds it, rolls it out arin, folds it; creating a structure that will eventually be a sheaf of thin layers. 1

There are unobservable orders of organization in nature, like the multilayering of phase space or French pastry. These are important to the behavior of objects in nature, and can only be discovered with the appropriate analysis. These hidden higher orders describe rules that govern the flow of information, only the effects of which can be observed. Observable, unobservable, lower and higher orders of organization are not too dissimilar to the notion of the conscious and unconscious mental realms. The unconscious realm lies hidden beneath the conscious, and by all accounts appears to be much deeper and larger than the conscious. This concept is similar to David Bohm's idea of an explicate order behind which lies an implicate order. The implicate order is enfolded or hidden within the explicate, but is neither observable nor measurable; it is only knowable through the existence of certain phenomena, because sometimes we are able to roll time backwards and perceive its manifestations. This implicate order is likewise much deeper and vaster than the explicate order. As Bohm himself states: It is being suggested here, then, that what we perceive through the senses as empty space is actually the plenum, which is the ground for the existence of everything, including ourselves. The things that appear to our senses are derivative forms and their true meaning can be seen only when we consider the plenum, in which they are generated and sustained, and into which they must ultimately vanish. This plenum is, however, no longer to be conceived through the idea of a simple material medium, such as an ether, wnich would be regarded as existing and moving only in a three dimensional space. Rather, one is to begin with the holomovement in which there is the immense "sea" of energy. . .. This sea is to be understood in terms of a multidimensional implicate order ... while the entire universe of matter as we generally observe it is to be treated as a comparatively small pattern of excitation.12

The notion of holomovement is a specific extension of the idea of a hologram. As we will see later, the holographic paradigm also has its place within acupuncture theory and practice, and may be an important component of the signal system. Homo sapiens are as much a part of this holomovement as all else. We are equally subject to the flow, storage, and transmission of biological information as are other organisms and are equally capable of manifesting expressions of this hidden order, of the latent tendencies enfolded into our genetic background. We can see numerous examples of this, many of which are described in the next two chapters.

The X-Signal System

25

CLINICAL EXAMPLES OF THE X-SIGNAL SYSTEM In acupuncture therapy, we can apply a very tiny influence (too small to be called a stimulus) to an acupoint and produce changes in an area of the body that is unrelated via neurophysiology. For example, we can place a north-facing magnet on the large intestine point in the auricle and the reaction at the large intestine source point, LI-4, on the same side decreases. Reversing the magnet in the auricle, so that the south pole faces the point, increases the reaction at the same LI-4. On the opposite auricle, placing the south-facing pole on the large intestine point reduces reaction at the original LI-4, while the north pole increases the reaction. The polarities reverse if we stimulate the opposite side. This phenomenon is essential to an understanding of acupuncture, as it demonstrates right-left, north-south antagonisms. We can cite many examples of hidden relationships in the body and of the action of the signal system. The next two examples are derived strictly from the clinical practice of renowned practitioners, medical doctors who, as practicing acupuncturists, have devised new methods of diagnosis. Dr. Reinhold Vall measures the DC electrical resistance at the jing points of the channels, next to the nails of the fingers and toes. He diagnoses channel and organ dysfunctions by their variations in electrical resistance. He uses homeopathic remedies as his treatments. This is his original method for selecting the appropriate remedy and quantity of remedy. He calls it "Medikamententestung." If this test describes some channel abnormality or organ dysfunction, he selects an appropriate remedy sample that the patient holds in one hand while the physician remeasures the points. If the numerical values are restored to normal, then this remedy is seen as appropriate for that patient's problem. His theory is that the remedy is able to affect the electrical resistance in the channels through the sample. This is not explicable through normal pharmacological action, but somehow the sample sends a signal through a glass ampule to bring about a measurable biological change. The second example is similar, although not quite so mysterious. Dr. Yoshiaki Omura has advanced the hi-digital 0-ring test, a type of kinesiological test, and reports similar phenomena. The patient tested makes a ring with the forefinger and thumb. The therapist tries to pull the digits apart, while the patient tries to resist. The degree of resistance is assessed by the therapist. If the patient has an organic disease, he is asked to place his other forefinger on the skin of a region affected by the disease, e.g., over the liver in liver problems. The patient exhibits little power of resistance. The therapist then retests the patient, while the patient holds a sample medication. If the medication is correct, the power of resistance will increase. If the dosage is too high, the patient will not have the power to resist. The signals involved somehow affect the power of grip. They must be stimulating the nervous system to change the grip, but what signals the nervous system is unclear. It is evident from these examples that these effects are not transmitted through anatomophysiological systems. Some other signal system is involved, part of what we have called the X-signal system.

TOPOLOGICAL COMPONENTS OF THE X-SIGNAL SYSTEM Our research and work have shown that the signal system is also related to more gross structural properties of the body. That is, some behaviors and functions of the body are closely tied to the three-dimensional structure or symmetry

26

The X-Signal System

of the body. For example, the body can be described by three-dimensional halves - upper-lower, left-right, front-back - as an octahedron, which can be shown to affect the behavior or functions of the body. As an example, we might examine the "pressure perspiration reflex" discovered by Professor Kentaro Takagi. He found that if pressure is applied to one side of the body, maximally at the nipple level, perspiration will occur only on the opposite side of the body. The dividing line will be at the exact center of the body. If pressure is applied, for instance, to the upper right side and the lower left side, perspiration will occur only in the upper left and lower right portions of the body. If the pressure is reversed, the perspiration is reversed, again with the dividing lines at exactly the center lines of the left-right, inferior-superior sections.

Figure 2.3: Pressure perspiration reflex on opposite quadrants of the body.

Similarly, if pressure is applied to a point on both sides of the upper body, perspiration will occur only on the lower portions of the body. These quadrantal relationships appear on both the anterior and posterior portions of the body and are not at all explicable by neurophysiology. Instead, they seem to be manifestations of a certain octahedral symmetrical tendency. This octahedral symmetry is enfolded or hidden within the body, manifesting only in specific conditions. We propose that this symmetry is an essential part of acupuncture theory, as well as of the signal system. Biological, clinical, and medical examples of this model can be found throughout this text. The general theory of the octahedral model can be summarized as follows: Prior to the current stages of evolution, organisms did not possess the complex information systems that now exist. Organisms had a primitive signal system, the X-signal system, which is now retained as a rudimentary biological information system. The reason some of the more subtle techniques employed in acupuncture can be so remarkably effective is that the X-signal system is accessed in some fashion.

The X-Signal System

27

The octahedral system is part of the hidden order. The signal system functions to access biological information derived from the structure and function of our primitive ancestors and our earliest stages of embryogenesis. This idea is essentially topological. Applying topological theory to biology we are able to explain the signal system in greater detail and trace its origins in evolution and embryology. More than this, taking a generalized topological view of the body as our starting point allows us to more clearly understand the relationships of structure and function, pathological deviations and normal variations (biases). From this, we have been able to devise simple but powerful treatment procedures and reliable diagnostic assessments. We may use a limited definition of topology: The study of those properties retained by an object under deformation such as stretching, bending, squeezing, but not breaking or tearing. One immediate consequence is that injury or surgery on the body with the formation of scars will disrupt the normal flow of information. This occurs not only as an "energy blockage," but as a distortion or disruption of the information flows associated with the properties describable by topology. A lump of modelling clay molded first into a sphere, then a cube and then some other random shape retains certain properties:

Figure 2.4: Modelling clay in sphere, cube, etc

Examples of these properties are: connectedness, separability, regularity, compactness. A donut-shaped ring of clay molded into a cup with a handle has the same properties as the cup, even though their appearance is different.

Figure 2.5: Donut

These shapes are homeomorphic. Similarly, a double-holed donut shape can yield a double handled cup, both of which retain the same properties.

Figure 2.6: Double handled cup

The size and shape of the object is not important in topological descriptions. By examining it from this perspective, we can propose descriptions of biological

28

The X-Signal System

systems and their properties that otherwise might not be made. Topological reasoning allows us to describe how octahedral symmetry, with its inherent properties, may have arisen through the course of evolutionary and embryological development. This may seem extremely abstract; however, the implications of this idea for biology are enormous. As with information theory, these properties do not need to be defined clearly. We can propose that this topological theory is a subset of information theory that pertains to certain aspects of information transmission and storage. It allows us, for example, to describe how phenomena occurring in the body can produce manifestations elsewhere. Just as we can define the flow of electrons, ions, and chemicals as information, so, too, can the transmitted effects described by the language and concepts of topology be classified as an (undefined) information flow. Recent studies in the geometry of nature describe properties that belong to the whole system being analyzed which are not describable with reference to the component parts of the system. Many of these studies have revolved around the investigation and description of chaos. It has been found that chaotic systems can spontaneously give rise to order. Underlying the seemingly chaotic systems are what appear to be universal layers of order, describable geometrically and mathematically: In the 1980s, chaos brought to life a new kind of physiology built on the idea that mathematical tools could help scientists understand global complex systems independent of local detai/.13

Interestingly, the use of this method is very effective for describing the hidden order contained within an object. Some, like Benoit Mandelbrot, believe that these geometric properties- in his words "fractal orders" -are universal in nature and require only a few rules to decode.l4 Perhaps the theories of yin-yang and the five phases are such rules. We can see more than structural relationships by the use of topology theory. The changes of an object through space and time come under the purview of topology; thus the normal timing of physiological events, of biorhythms, also falls within its realm.15 We can use this to reexamine the classical Chinese descriptions of biorhythms where the flow and interrelationships of the channels, the numerous five-phase relationships, can be viewed from an isophasal perspective. "Isophasality" refers to the synchronous harmonic effects, or resonances, pertaining to the various phase shifts of bioenergetic and biorhythmic occurrences.l6 For example, in clinical practice, if we find a pattern of synchronous occurrences in the body- areas of tenderness, tension, pulse qualities, and symptom complexesthat correlate to the earth phase, then the earth points of each of the channels are therapeutically available, especially those of the more biorhythmically active channels. By whatever means, these acupoints resonate with or are in harmony with that specific pattern of phase energetics and can have profound effects upon it. All earth points are isophasal, having in common some properties not shared with other points. The same commonality can be found to hold true for other classes of points. With delicate experimentation and examination we have been able to map some of these properties. We can also look at both evolution and normal development from a topological perspective. From the moment of conception to the moment of death, the organism retains essentially the same topological structure, the same homeomorphic properties, even though it has undergone numerous changes and transformations. Organisms thus retain certain properties that may or may not have manifested at

The X-Signal System

29

these various stages of development. Clinically, we can draw parallels between t~e first divisions of the fertilized ovum to the dividing lines of the left and right

sides of the body, the axis of the ren mai and du mai in classical theory, and the dividing lines of the superior and inferior parts of the body, the axis of the dai mai in classical theory.

@

r-------------~~--------------~

Single Cell

RenMa~ DuMai ~

~

RenMai, DuMa-i

TwoCells

11--J,Qt Four CeUs

DaiMai

9

II•

0

Figure 2.7: The first division gives rise to the ren mai-du mai axis. The second division gives rise to the dai mai axis.

Thus, we can see the possible embryological roots of octahedral theory, as the left-right, superior-inferior portions are clearly delineated in this development. The anterior-posterior portions may be delineated in the same manner. The physical body retains properties that were active and important at all stages of embryogenesis, many of which are now latent, awaiting the correct stimulus, circumstance, or bias, to manifest again. Evolution can be viewed as the progressive extension of topological principles and properties. If for example, we take a simple donut-shaped structure, we can imagine the hole on one side representing a mouth and the other as the anus:

I§ Figure 2.8: Donut shape

As this donut shape is flattened, we can derive a tubular structure, somewhat similar to primitive organisms, such as a worm, with a mouth, gut tube and anus:

Figure 2.9: Tubular structure

Manipulation of various areas of this tubular organism yields elementary limb formations, as are found in fish fins:

Figure 2.10: Fish limb formation

30

The X-Signal System

Further development of these structures yields the arms and legs. Finally we arrive at structures like those of mammals and indeed people:

Figure 2.11: Structural outline of mammalian and human forms

Because there is continuity in the reproductive cycles of successive generations, where development occurs against the background of genetic information, we can argue that organisms alive today, such as mammals, fish, and people, all retain those same properties that were present in the earliest and throughout all later stages of evolution. Schoffeniels states this point quite clearly: The content of a biological system increases in the course of its development since it represents an integration of all the modifications which it has undergone and which it has imposed on the environment/?

Within the body many such systems exist, each of which are subsystems and have subsystems within them. Properties that developed early on in the evolution of these systems will have been integrated into the total biological system. Whether or not these properties manifest depends mostly on need and response. If they are not needed for survival, they may not manifest since that would represent an unnecessary expression of information, a waste of energy. Their manifestation would be obviated as well by the evolutionary development of more efficient information systems, such as the neurological system, having specific targets, hormones and other molecules with specific on-off activation sites. These supercede, but do not eradicate, the more primitive properties that belong to the signal system. The more primitive systems may be made to manifest in response to the correct stimulus. We can give numerous examples to demonstrate these ideas. We propose that some theories and techniques of acupuncture either describe certain of these properties or use them to obtain therapeutic effects. Yin-yang, channel, and fivephase theories have proven successful tools for exploring and taking advantage of the signal system. ExPERIMENTS WITH THE BIOELECfRICAL NATURE OF THE X-SIGNAL

The information flow of the signal system can be viewed as molecular and/ or electrical in nature, though some of the preceding examples suggest that there are other mechanisms at work. While certain molecular and electrically mediated effects of acupuncture and moxibustion have been documented in various researches on the anatomophysiologic system effects, the subtle effects pertaining to the signal system have not been clearly defined. From our own research we can suggest that some are electrical or electromagnetic in nature. Our main reasons for saying this are as follows:

The X-Signal System

31

1. With the correct application of polarity agents to the body, we are able to bring about almost instantaneous changes, such as decrease or increase of pressure pain and tension at specific acupoints. These rapid changes occur too quickly for them to be molecular. As we have already stated, stimulus from polarity agents is too minute to affect the nervous system, so neither are the effects neurological.

2. The various polarity agents that we can use for testing and treating operate essentially from an electrically positive and negative polarity, and thus we can reason that their effects are at least in part electrically mediated. Examples of these polarities are as follows:

Polarity agent two-metal contact bi-polar magnet contact* digital contact ion-pumping cords ion-beam apparatus electrostatic adsorbers * See

Positive

~~fger north pole thumb red clip red electrode positive stick

Negative zinc silver south pole little finger black clip black electrode negative stick

the glossary for magnetic pole definitions

These various polarity agents produce repeatable results and effects. Reversing polarities will reverse the effects. For example, ST-27 is the Manaka diagnostic point for the large intestine. If right ST-27 has pressure pain, placing a north-facing magnet on right Ll-4 will decrease the ST-27 pressure pain. Reversing the magnet so that the south pole faces to right Ll-4 will cause the ST-27 reaction to return. This reversibility eliminates the possibility of a placebo effect or another psychological phenomenon, and demonstrates that a genuine response is occurring. Although these tests cannot be repeated indefinitely, this type of procedure can be applied on a specific point several times, after which the reactive points will become insensitive regardless of the polarities applied. This may occur because of overstimulation, with the flip-flop effects of polarity reversal. When the two-metal contact technique is used, the electrical effects are similar to, but differ from, a metal battery. These two metals do not make contact as in a metal battery because they are not inserted into the body fluids, but are placed on the body surface. A metal battery has two metals inserted into a conducting medium. We know from experiments, clinical results, and observations, that each of these agents produces some electrical polarity so that minute electrical currents flow, but these are very difficult to measure; often they are simply too small to measure. We can further suggest that the mechanisms of these minute currents are probably one or more of the following: 1. The semi-conductor network of the interconnected large molecules throughout the body described by Szent-Gyorgyi and Oschman.18 2. The ionic currents that flow through the cardiovascular system from various local microscopic areas to other local microscopic areas, described by Nordenstrom.19 3. The DC electrical current system said to flow through the perineural cells, described by Becker.20 4. Other currents as yet not clearly mapped and other systems as yet undescribed.

32

The X-Signal System

Many of these effects and mechanisms are denied or ignored by researchers because they are hard to measure. Anatomophysiologic system effects, the effects of acupuncture and moxibustion on the neurological, neurohumoral, hormonal and cardiovascular systems, are easier to measure and document. The essential problem is that both the anatomophysiological system and signal system are activated when the body is stimulated using needles and moxa. Since the anatomophysiological effects are clearer and more easily measured, these tend to obscure the subtler signal system effects. But using polarity agents, applying very small biases to the body, we can bypass the anatomophysiological system effects and thus more clearly observe the signal system at work.

BIASOLOGY The concept of bias is useful for describing very subtle influences in the body. We might go so far as to say that the concept of bias is an important idea for handling the hidden aspects of the body, as they pertain to the functions of the signal system and thus the theories of acupuncture and moxibustion. A bias can be described with examples such as the following: 1. In bowling, the lopsidedness of a ball causing its curved path.

2. A mental inclination or leaning. 3. A slanting or diagonal line cut or sewn in cloth. 4. In engineering, a steady force, voltage, magnetic field, applied to a device to establish a reference level or determine a range of operation. In the medical field we can find examples of biases, such as the methods of Drs. Vall and Omura which utilize the bias effects of substances brought in close contact with the body surface. In psychoanalysis the concept of the Freudian complex can be seen as a bias. A small incident in a patient's childhood biases that person throughout their life until they confront the incident and relieve the bias it creates. Similarly, an irrational fear of spiders or monsters can be a hidden bias. In our own practice we once had a nurse come for treatment of shoulder pain. She had a scar on her lower limb from an osteomyelitic problem that had occurred many years before. Injection of one cc. of novocaine subcutaneously into this scar eliminated the shoulder pain. In this case we can describe the old scar as biasing the body and causing secondary problems. This can happen with any scar and has been reported as a common problem with scars from abdominal and other surgeries. Similarly, a patient who came for treatment of chronic shoulder and low back pain felt that she had nowhere else to tum and was depressed about her condition. After good results had been obtained, it was necessary to relieve the mental bias she had concerning the condition, which had predisposed her to perpetuate the condition. To prevent its returning, an anti-bias was given by simply telling her that the Western disease name she had been given was no longer accurate. Since simple treatment of her liver channel was able to cure the condition, it was only a liver channel problem. She was told that she should stop worrying about it, a tactic that proved successful. After the war, I had a distraught male patient who was depressed, anxious, and worried that he was dying. His family was concerned as he was slowly wasting away and seemed very sick. Recognizing that the man had nothing organically wrong with him, yet might well eventually die because of the emotional bias, I told him that as an experienced doctor I was always able to predict when a patient was soon to die and that I would tell the patient when this was about to happen, but that in his case it was not going to happen now. Of course, because the patient trusted

The X-Signal System

33

me, I was able to counterbias the negative bias and the man recovered soon thereafter. Only recently did I hear from the man's family that he had passed away, some forty years after he was "dying." Other examples of bias might include a patient with a toothache, who creates a secondary distortion and bias by chewing only on the side that does not hurt, so as not to irritate the toothache. This causes other problems later. Any repeated imbalance movement can trigger a bias. Someone who writes extensively with only the right hand, or who plays tennis only with the right arm, will bias the body and eventually may have problems. We can see that in each case we need an anti-bias or a suitable counter-bias for the particular problem at hand. This requires a simple means for finding the bias and a simple means for testing the applicability of a particular counter-bias. A successful counter-bias will release the bias and allow both the secondary bias effects and the original functional problems to change. The use of polarity agents to achieve this is extremely helpful, especially because the polarity agent itself generates a tiny electrical/magnetic bias. When applied to the appropriate points, this can be a very potent counterbias. Thus we can use the study of biases, biasology, as a useful means for examining our diagnostic and therapeutic approaches, since it allows us a multi-disciplinary synthesis and rationalization of our understanding of the body's hidden signal system, the X-signal system. We can use the concept of the bias outside of the medical realm to examine other facets of the signal system. For instance, in the practice of Zen Buddhism, there is the concept of satori. This refers to a particular conscious state that is achieved at a particular moment in time. Usually satori occurs when some small phenomenon occurs, such as the sound of a bamboo shoot falling in a bamboo grove, or the light tap of the zen monk's staff on the subject's shoulders. These are clear examples of bias, a tiny stimulus given at a critical moment. In the realm of biometeorology the tiny but significant effects of the geomagnetic field are seen as a favorable bias to the organism, as they are essential to the correct timing and integration of physiological events. In all cases, the bias refers to some minute or subtle influence, analogous to the minute signals of the X-signal system. When we apply such a minute stimulus or bias, we are able to observe the topological nature of acupuncture and moxibustion theory and practice. We can also observe some of the complex relationships between structure and function, symmetry and asymmetry. Using these observations, we have derived new clinical laws, rules, and methods of treatment. For instance, looking at some of the body's natural asymmetries, such as the position of the liver and gallbladder on the right, and the stomach, spleen, and heart on the left, we might expect to find particular asymmetrical patterns, if any of these organs or their associated function sets develop problems. We would expect these asymmetries to bias the body in particular patterns. This is what we actually find. The liver, being in the upper right abdominal quadrant, will produce a particular pattern of tension and pressure pain in the body. The right-sided subcostal tension that develops as a result of a functional liver problem in fact biases a whole set of muscle groups, producing a range of other problems. Reactions often will be found on the left sartorius, left internal oblique, right external oblique, right serratus anterior, right rhomboideus major, and the right rhomboideus minor muscles when liver problems occur. This particular spiral of muscle bands is a functional set, as can be demonstrated using kinesiological

34

The X-Signal System

techniques. It is associated with the liver, because the liver is in the upper right abdominal quadrant and tends to bias this muscle set.

Figure 2.12: Functional muscle group

A simple procedure such as placing the right hand palm down on a magnet heater, or the left foot sole down on a magnet heater, will generally release these tensions and tendernesses throughout the functional muscle set. In releasing the pattern of muscle reactions, the body structure is subtly altered and liver function improved. Any number of procedures can be used to achieve the same effects, their goals generally being to relieve reactions of the upper right and lower left body areas. Ideas such as bias can be useful in this context. A bias can be an unbelievably small event that radically changes the behavior of a whole system. It can change the system in a favorable direction or an unfavorable direction. In this sense it is similar to the low-level signals which we have postulated lie at the heart of acupuncture practice. Small, seemingly insignificant changes in the body develop; these bias the body and cause functional changes to occur. Development of tension throughout the spiral band of muscles that cross over the liver slowly causes functional changes in the liver. Application of a small dose stimulation bias - can push - bias - the body so that it tends towards a more healthy or normal functional state. Disease may begin at a sub-cellular level and then spread, biasing the rest of the system. Treatment can similarly start at a very minute but strategically powerful level, and counter-bias the system. Using the meridian imbalance diagram (M.I.D.), we are able to confirm these observations objectively and track a patient's progress before, during, and after treatment. The M.I.D. procedure was specifically designed as a means of observing and statistically demonstrating structure-function relationships, particularly octahedral relationships. It provides simple, objective statistical measures of a patient's overall energetic state, described in classical theory as yin-yang balance. When we consider the effects of acupuncture and moxibustion therapies as occurring primarily through the X-signal system and secondarily through the anatomophysiological systems, we can also gain insight into the possible mechanisms of action that infuse both classical and modern clinical observations and systems. For instance, why is it that one point on the body surface can be observed to affect one area or part of the body and yet a point close to it, in the same dermatome, can affect a totally different area or part of the body? It seems clear that these effects cannot be neurological. Further, how can we understand the various simple and complex systems of reflexology? We can find modern descriptions of how all parts of the body reflect

The X-Signal System

35

somewhere on the feet, hands, nose, eyes or auricles. (Of these, the hand reflexology of Tae Woo Yoo and the auricular reflexology of Nogier and the Chinese are particularly useful.) As we have already suggested, if we consider the theories of the holographic paradigm, where all aspects of the whole reflect or contain all other parts of the whole, as descriptive of part of the signal system, we can begin to see how such systems may work. These reflex points and areas are able to receive and send very specific information to specific areas of the body.

THE X-SIGNAL SYSTEM IN ACUPUNCTURE &

MOXIBUSTION THERAPY

It is important that we do not confuse the neurological and humoral effects of acupuncture, so thoroughly researched and described in needle analgesia and anesthesia research, with the signal system effects. The analgesic and anesthetic effects are seen to a lesser degree in normal acupuncture and moxibustion than when deliberately applying acupuncture analgesic and anesthetic techniques. Likewise the signal system effects are seen to a lesser degree in normal practice and more clearly in the subtle practices of the traditional keiraku chiryo, or channel (meridian) treatment schools, when very tiny influences are given in treatment. Acupuncture anesthesia uses strong stimulation and counter irritation to produce anesthetic and analgesic effects. In the American movies, when a cowboy was shot, his friend would feed him whisky and then apply an upper cut to the jaw. Then the friend could remove the bullet lodged in his body. Acupuncture anesthesia is like this. With a strong stimulation, people become faint; if the stimulus is strong enough, the operation is easy. But we should not think of using acupuncture anesthetic methods for treatment of general or subtle problems! While admittedly it is difficult to discriminate the clearer neurological and humoral effects of acupuncture from the subtler effects of the signal system, if we consciously try to use the signal system, we can produce remarkable results. This is because this system participates in the therapy regardless of whether we think about it or not. Our research suggests that the clinical effects of channel therapybased acupuncture that we describe in this text occur primarily at the signal system level. The signal system either regulates the informational systems in the body, which in turn regulate the energy systems, or it directly regulates the energy systems. Either way, if we can learn to control the signal system, which requires only the tiniest energy or signal input, we can produce dramatic effects throughout the information and energy systems. If there is an error signal in the information system and we learn how to correct this signal, many problems in the energy systems can be corrected. Because the observations of these error signals require only simple diagnostic checks and are corrected by tiny influences or energy inputs, simple diagnostic and therapeutic systems can be developed. Indeed, because the input required is so small, we are often able to stimulate or influence the body with only a simple touch or non-invasive application. Since needles may not be used or needed, the risks are greatly reduced and safety greatly enhanced. Before finishing these discussions of the signal system, let us briefly return to our earlier question of how it relates to the theories of acupuncture and how, for instance, might we understand the rather difficult concept of qi. In the last chapter we looked at the problems involved in accurately translating the term qi. We can now state more clearly that the term is untranslatable into a specific Western word. Rather, it should be rendered as vague and wider term, such as "information." Qi has uses that imply physiological process. In this sense information

36

The X-Signal System

refers to the whole sequence of events in the process and may involve all the known equivalent biochemical and physiological components. Qi also has uses and functions that imply less tangible processes, transformations, and exchanges. The term "information" is equally vague, referring only to the fact that something is transmitted, transformed, or produces change. Qi does work, is the result of work done, and is the medium of regulation. Yin-yang and the five phases have the same difficulty of translation. In the medical literature, many of these functions can be clearly described in the terms we use to explain the information and energy systems: the neurological, biochemical, storing, dissipating, or assimilating functions of modem biomedicine. Yet, many of the functions and ideas described by the ancient Chinese cannot be rationalized in that way. All we have are descriptions of various qi functions, movements, interfaces and transformations. The Chinese descriptions are like a qi signal system, parts of a larger system, the X-signal system in our words. Relative to their uses in classical medical literature, we can now explain these terms with reference to the signal system model that we have developed. The terms "yin-yang" and "five phases" are used to categorize and describe interrelationships. In signal system terms, they describe the characteristics of components of the whole body and how they interact and regulate, at a primitive biological level, through information/ signal exchange (qi). The twelve channels represent pathways of information/signal transmission and sites of information/ signal reception. Thus, they have yin-yang and five-phasal characteristics and acupoints. The eight extraordinary vessels represent what are probably the remnants of a primitive biological structure that functions to globally regulate the body, through distribution of qi, both in the sense of what does work and what regulates activities - information/ signals. One final question we should raise: what is it that prompted the ancient Chinese to describe these things? How were they able to observe and discern things that are virtually undistinguishable to us in modem times? We have proposed already that perhaps they were using more right-brain pattern recognition and observation. In the West and in modem times, the tendency is to use left-brain patterning. If this is true, then we can say that the ancient Chinese had a finer, more developed sense of intuition. Perhaps because of their simpler, more natural life styles, they may have been more attuned to natural phenomena and could perceive aspects of nature that are difficult for us to see. This would be true of all simpler, more natural cultures, not just the ancient Chinese. We can cite the Micronesian natives who had the ability to navigate thousands of miles over open waters in small sailing boats without maps or compasses. While it is harder for us to see these aspects of nature that are now hidden for us, we can use the same rules that the ancient Chinese described. With careful application, we may discern and observe these rules and devise methods of using them with powerful clinical effects. We can now examine more thoroughly some traditional acupuncture theories and show with simple experimentation (that you may repeat for yourself) how the signal system rests at the heart of acupuncture as its modus operandi.

CHAPTER ENDNOTES 1 S.B.: The term "Meridian Imbalance Diagram" has been retained because of the number of papers already published which refer to it as such. 2 S.B.: Even the queen and royal family of Britain have an homeopathic doctor as their primary care physician. 3 See The American Homeopathic Association Bulletin. 4 English Homeopathic Journal, 1954.

The X-Signal System

37

5 S.B.: For an interesting discussion of scientific research into the effects and mechanisms of homeopathy, see: Manning, C.A. and L.J. Vanrenen, Bioenergetic Medicine East and West, Berkeley: North Atlantic Books, 1988, pp. 65-89. 6 Davenas, E. eta!., "Human basophil degranulation triggered by very dilute antiserum against IgE," Nature 333:816-818, 30 June, 1988. For the disclaimers of this study, see pages 787 and 818 of the same issue of Nature. 7 Ibid. 8 In acupuncture, this is relatively easy to demonstrate. Normally, placing a small, north-facing magnet at LU-10 will reduce the tension and pressure pain of LI-4 on the same hand. If instead the magnet is held anywhere from a few centimeters to several meters away from LU-10, while pointing the magnet at LU-10, the same effects can be observed as when placing the magnet directly on LU-10. However, this occurs only when the magnet is held east of the acupoint. If the magnet is held to the north, west or south, the effect disappears and the pressure pain at LI-4 is unchanged. This effect can be observed using other tools and other points. See Appendix 4 for further presentation of sayoshi. 9 S.B.: See for example studies on the partial regeneration of fingertips accidentally severed in children, where regeneration only occurs under special conditions. Illingworth, C.M. and A.T. Barker, "Measurement of electrical currents emerging during the regeneration of amputated fingertips in children," Clin. Phys. Physiol. Meas. 1:1,p.87-89, 1980. 10 Lovelock, J., Gaia: A New Look at Life on Earth. 11 Gleick, J., Chaos, p. 149. 12 Bohm, D., Wholeness and the Implicate Order, pp. 191-192. 13 Gleick, J., Chaos, p.280. 14 Ibid., p.238. 15 See for example Winfree, A.T., The Geometry of Biological Time, New York: Springer-Verlag, 1980. 16 Amore clinically based definition of the term "isophasal" can be found in chapter six. 17 Schoffeniels, E., Anti-Chance, p.103. 18 Oschman, J.L., "The connective tissue and myofascial system," Rolfing 1981 conference, unpublished paper. 19 Nordenstrom, B., "Biologically closed electric circuits: clinical, experimental and theoretical evidence for an additional circulatory system," Stockholm: Nordic Medical Publications, 1983. Taubes, G., "An electrifying possibility," Discover, April1986, p.23-37. 20 Becker, R.O. and G. Selden, The Body Electric.; Becker, R.O. and A.A. Marino, Electromagnetic Fields and Life.

SECTION

Two

IN PURSUIT OF THE DRAGON

RESEARCHING AND EXAMINING TRADITIONAL THEORIES AND CONCEPTS

the universe is a vast organism with now one and now another component taking the lead - spontaneous and uncreated it is, with all the parts of it cooperating in a mutual service which is perfect freedom, the larger and the smaller playing their parts according to their degree.''

J. Needham, Science and Civilization in China II p.288.

CHAPTER THREE

YIN-YANG THEORY The concepts of yin and yang are central to the theories of East Asian medicine. Explication of these terms in the professional literature depends on context, author, and era; their meaning carries as many subtleties, nuances, and facets as the term qi. The multiplicity of their correspondences make it difficult to design an encompassing and coherent definition. Even the use of terms like "positive" and "negative" to express their polar nature is inadequate. There is clearly no scientific definition available. For the purposes of our research, we propose to use clinical procedures and tests to focus and clarify our understanding of these concepts. Many conceive of yin and yang as fixed entities or ideas, sometimes almost palpable entities. Our perceptions and methods of analysis always define the polarities with various syntagonistic and antagonistic tendencies. It is difficult to see the underlying, indivisible unity of which yin and yang polarities are but appearances. Realistically, they are just relative ideas, simultaneously syntagonistic and antagonistic, complementary and opposite. In some sense they are like a moebius strip. First examination shows two surfaces, and we can say that one side appears yang, and the other yin; but with closer inspection we find that there is only one surface: its duality is just a relative appearance. We can further imagine that the relative balance of yin and yang surfaces in the body form a large, complex mobile:

Figure 3.1: The balance of a mobile

42

Yin-Yang Theory

Here many pendants balance antagonistically against one another, often with one against many at the various fulcra. Total balance and harmonization consists of all the partial balances throughout the mobile. Left-right balance is not free from the superior-inferior or anterior-posterior balance. All facets are organically related. Different parts can become unbalanced, but generally the whole remains relatively balanced. The concept of balance is not a rigid, strictly defined idea. In dynamic systems such as the human body, or nature in general, rigidity is not possible. Balance is always an oscillation around a reference point. For example, a pendulum always appears to swing back and forth over the same point, but its real motion is much more complex. When analyzed statistically it appears to be balanced; but at any particular time, its motion may not be balanced at all. When standing upright, the center of gravity always sways back and forth over some reference point that lies directly below the center of the body. Blood pressure, body temperature, and probably all physiological processes oscillate through some normal range. This homeostatic process is vital in dynamic and living systems. Without it, order likely could not prevail. The concept of balance is thus flexible and not rigid. Yin and yang balancing or harmonization is something similar; it is always relative and moving. Such are the dynamic balances of life. Historically, in Chinese medical tradition, yin and yang were viewed as opposite polarity concepts used to assess disease and to design treatments to restore balance. We think that there are two ideas basic to this concept. First, there are concepts relating to changes within the environment: terrestrial, celestial, bodily, seasonal, and the changing condition of the disease. Yin increases, peaks, and gives rise to yang. Yang increases, peaks, and gives rise to yin. This concept has been described extensively, and many familiar examples can be cited. For example, during the course of a year the relative state and flux of yin and yang is quite complex. At the summer solstice, in June, yang energy is said to be already peaking, after which it begins to decline, while yin ascends. But in actuality, the warmest days come in July and August, after the actual peak of yang, during the time yang is declining and yin ascending (yang gives rise to yin.) There is a lag between reality and appearance. This same phenomenon occurs during the winter: yin peaks at the winter solstice in December, but the coldest days come in January and February. In this context, yin and yang are not absolute and separate. In yin there is yang and in yang there is yin, as is graphically portrayed in the yinyang taiji symbol.

Figure 3.2: The tai ji symbol

YIN-YANG IN TOPOLOGY The second perspective views the yin-yang components of the physical body as a system of syntagonistic-antagonistic relationships. We say that these are topological relationships. This differs from the first concept of yin and yang within and

Yin-Yang Theory

43

engendering one another. Now we consider yin and yang as separate: in yin there is no yang, in yang there is no yin, and there are relatively clear yin-yang boundaries. This second concept has been given little attention in the field, yet it is a perspective that we have found particularly useful because it correlates to the channel system, and the flow and regulation of qi. The classical yin and yang correspondences, such as those referring to the structural, topological relationships of the body, have notable clinical utility. Body portions superior posterior inferior anterior

yang yin

left right

If we take these three structural, functional yin-yang divisions and draw "dividing lines" as polar axes of the body, we can define eight areas of the body, eight octants. Together these illustrate octahedral theory, the concept of a structural symmetry enfolded into the body. left-right posterior dividing line

left-right anterior dividing line

Yang

superior-inferior dividing line

Yin Figure 3.3: Structural octahedral body symmetry

Research abounds which corroborates octahedral theory. The pressure perspiration reflex tests of Professor Takagi are one example, mentioned earlier. Takagi demonstrated that these perspiration effects could be elicited with needle stimulation to single acupoints. Interestingly, he found that shallowly and deeply inserted needles elicited different responses. Stimulation that clearly produced strong nervous system reactions (deeper needling) did not manifest this octahedral symmetry. Needling with little (or no) nervous stimulation was able to manifest the symmetry. Our theory of the signal system, responding to tiny electrical bias or stimulation, predicts such differences. Other biological and medical examples of octahedral symmetry can be referenced.1 The non-pathological harlequin flushing of the newborn clearly manifests left-right asymmetries.2 The familial condition, painful harlequin flushing, manifests clear left-right, anterior-posterior, and superior-inferior asymmetries.3 Some researchers have noted left-right, superior-inferior asymmetries in the distribution of biopotentials.4 Superficial lymph drainage is clearly quadrantaJ.S Opioid peptides have shown left-right, inferior-superior, medial-lateral limb specificity in acupuncture analgesia.6 We have devised simple tests to demonstrate and validate the octahedral model. The use of north and south magnets on the large intestine points of the a uri-

44

Yin-Yang Theory

de to relieve pressure pain at LI-4 is one example. If right LI-4 has pressure pain, north (+) at the right large intestine point of the auricle will reduce the reaction, while south(-) will increase it. South(-) to the left large intestine auricle point will reduce reaction, while north (+) will increase it. We can take this simple experiment further. First, we can compare left and right LI-4 points after each application of the magnets. Second, we can also place the north and south magnets on the points directly behind the large intestine points on the posterior surface of each auricle. When doing this we obtain the following results: Magnet

Auricle point

RightLI-4

Left Ll-4

north(+) south(-) south(-) north(+) south(-) north(+) north(+) south(-)

right LI point right Ll point behind right LI pt. behind right LI pt. left LI point left LI point behind left LI pt. behind left LI pt.

decrease increase decrease increase decrease increase decrease increase

increase decrease increase decrease increase decrease increase decrease

We can see that it is difficult to reduce the reaction on one side without increasing the discomfort on the other side. A north magnet syntagonistically affects one side, the same side, and in so doing it antagonistically affects the other side. In this relationship the magnetic polarity has relative effects on LI-4 of one side of the body that are dependent on left-right, posterior-anterior antagonisms. This pressure-pain relief method causes relief on one side, but creates an antagonistic pain on the other, further demonstrating the structural symmetrical properties enfolded into the body which we postulate are the product of evolutionary and embryological development, and part of the X-signal system. This same type of test can be applied to other auricle points to elicit the same pattern of changes. For instance, for a subject experiencing pressure pain at LR-14, we can place north and south magnets on the left and right auricle liver points and on the points directly behind them on the posterior surface of each auricle. This gives the following results: Magnet

Auricle point

Right LR-14

Left LR-14

north(+) south(-) south(-) north(+) south(-) north(+) north(+) south(-)

right liver point right liver point behind right liver pt. behind right liver pt. left liver point left liver point behind left liver pt. behind left liver pt.

decrease increase decrease increase decrease increase decrease increase

increase decrease increase decrease increase decrease increase decrease

The same pattern of responses- right-left, anterior-posterior polarities- again occurs. These examples also indicate that the auricle points manifest on the posterior portion of the auricle, directly posterior to the same point on the anterior portion, where most of the auricular points are located. These points seem to show antagonistic tendencies. In the physical octahedral body, applying north and south magnetic poles to points on one side of the body will cause reduction of pressure pain on a point on the same or opposite side. We can demonstrate not only the right-left, anterior-posterior antagonisms, but also the inferior-superior antagonisms. If we place two strong magnets (over three thousand gauss) with north and south contacting either side of the anterior and posterior midlines, we can produce reductions in pressure

Yin-Yang Theory

45

pain in specific areas of the abdomen. These areas vary according to where we place the magnets:

~~

~~ J, ! ------+-------

® !@,J.

------+-------

~

~

Figure 3.4 (i)

Figure 3.4 (ii)

(i) - If we place a north magnet to the left and a south magnet to the right of the midline above the navel on the abdomen, pressure pain on the left side of the abdomen reduces (ii) - If we place the two magnets below the navel line, north on the left and south on the right, the right side of the abdomen shows pressure pain reduction.

This procedure compares the right-left dividing lines. If we then try the same experiments with the anterior-posterior dividing lines, we find the following:

~~ J.

!

------+-------

~ Figure 3.4 (iii)

(iii)- Placement of the magnets on the back again reverses the effects. Above the navel line, north on the left and south on the right produces reduction on the right side of the abdomen .

~~ !J,

------+-------

~ Figure 3.4 (iv)

(iv)- Below the navel line, north on the left and south on the right produces reduction on the left side of the abdomen .

N = north magnet S = south magnet

.U. =reduction of pressure pain

1t = increase of pressure pain

46

Yin-Yang Theory

~~~ J

('(\

~

./

! \_ t! ------+-------

(~k-kl

(~\ Figure 3.4 (vi)

Figure 3.4 (v)

(v)- Placing south on the left lateral side of the chest on the anterior portion and north on the left lateral side of the chest on the posterior portion will cause a reduction in the upper right quadrant (URQ) and lower left quadrant (LLQ) reactions . (vi)- Reversing the positions of the north and south magnets causes the URQ and LLQ reactions to return.

(backside!

t

!

------+-------

(-kside)

(~}_

~ ! ------+-------

1~\

Figure 3.4 (vii)

Figure 3.4 (viii)

(vii)- Repeating the same test procedure on the right side will cause the phenomena to reverse. South on the right anterior and north on the right posterior lateral portions of the chest will cause the URQ and LLQ reactions to increase. (viii)- North on the right anterior and south on the right posterior portions of the lateral chest will cause the URQ and LLQ reactions to decrease.

~~ ~~ t! ------+------- "' ® t® ,......... {~\ Figure 3.4 (ix)

! !

®

------t------® I J, / ~\

AT(""'

tbachideJ

Figure 3.4 (x)

(ix) - Placing south on the LLQ and north on the lower left lumbar region causes the URQ and LLQ reactions to increase. (x) - Placing south on the RLQ and north on the right lower lumbar region causes the URQ and LLQ reactions to decrease.

N = north magnet S = south magnet

.U. = reduction of pressure pain

1t = increase of pressure pain

Yin-Yang Theory

47

If we use this method to examine the boundary lines that pass through the navel to delineate superior and inferior regions, similar reversals of reactive areas occur depending on the polarity of the magnets. These simple tests clearly demonstrate all three sets of antagonisms and polarities that compose the octahedral model. What is significant here is not just the particular mechanisms that underlie each expression of octahedral antagonism, but also the general rules behind all these mechanisms. The fact that the body manifests a set of antagonisms is most important. We must ask: what are the biological functions of such a structure? We have speculated on the role such a system may play in the management and distribution of energy. In primitive organisms this would be a very significant aspect of regulation. In higher organisms its significance may be reduced by the multiplicity of other mechanisms that have evolved, but it may still play a biological role similar to the role it plays in more primitive organisms. In terms of acupuncture and the regulation of energy (qi), the octahedral antagonism is significant. The boundary lines of this octahedral symmetry are all yin-yang antagonisms: inferior-superior, anterior-posterior, right-left. As we shall see in later chapters, we can devise powerful treatment procedures based on octahedral theory, which is an essential part of the overall picture, the signal system.

CHAPTER ENDNOTES 1 In chapter two we also referenced our development and use of the M.I.D. as an objective, statistical means for demonstrating the octahedral model. See also, Matsumoto, K. and S. Birch, Hara Diagnosis: Reflections on the Sea, pp. 228-231. 2 See for example: Mortensen, 0. and A. P. Stougard, "Harlequin colour change in the newborn"' Acta Obst. et. Gynec. Scandinav. 36, 352-359, 1959. 3 See Hayden, R. and M. Grossman, "Rectal, ocular and submaxillary pain," Amer.Jour.Diseases Childhood 197:479-482, 1959. Dugan, R. E., "Familial Rectal Pain," Lancet, April1972, p. 854; Mann, T.P. and J. E. Gee, "Familial rectal pain," Lancet, May 1972, pp. 106-107; Diggle, J. H., "Familial proctalgia with painful harlequin flushing," unpublished manuscript. 4 Hori, S. et al., "Objective consideration of the correspondence between pulse diagnosis and quadridemarkation of the body," abstract, Amer. Jour. Acup. 13:1, p. 80, 1985. From Jour. Jap. Soc. Acup. 33:4, p.420-426, 1984. 5 See for example Kapit, W. and L. Elson, Anatomy Coloring Book, p. 69, New York: Harper & Row, 1977. 6 Edisen et al., "Regional and lateral specificity of acupuncture-induced action of blood-factor effects inhibiting flexor reflex in the rabbit'" Physiol. Chern & Phys. & Med. NMR 15, p. 189-199, 1983.

),1'.\~

Y~~~

~

CHAPTER FOUR

THE CHANNEL SYSTEM: /ING LUO THEORY Like yin-yang, the concepts of the jing luo, the channels or meridians, and their xue, the acupoints, are central to the traditional theories of acupuncture and moxibustion. Along the course of the channels were said to flow the qi, blood, ying, and wei. Each channel was described as having a direction of flow and as being connected in a continuous circuit. On this circuit the more than 360 acupoints were described by their locations, categories, and general use. The term jing luo refers generally to the channel system, but this involves more than the vertical trajectories, the jing mai, and includes the connecting horizontal trajectories, the luo mai. Other channel systems in the body describe different functional sets. Each category has different associated functions, with overlappings among all categories. Type No. Function jing mai (primary channels) 12 connecting to internal organs & external luo mai (connecting vessels) qi jing mai (extraordinary vessels) jing jin (channel sinews) jing bie (channel divergences) jing shui (water channels)

15 8 12 12 ??

limbs & joints interconnect the organ-channel system regulate the channel system connect with body musculature branching & leading back to the channels referenced only briefly and obscurely

The acupoints are found only on the shi si jing (fourteen channels): the twelve jing mai (primary channels) and two of the qi jing mai, the ren mai and du mai. All other channels intersect acupoints on these fourteen channels and have no acupoints of their own. According to our model, use of the twelve primary channels, the channel sinews, and the extraordinary vessels are usually sufficient to regulate the body through the octahedral and (iso)phasal components of the signal system. If we examine aspects of their nature, origins, and functions, and apply it to our model of the signal system, we can discover how the twelve primary channels, the channel sinews and the extraordinary vessels regulate the body through the octahedral and phasal components of the signal system. Few attempts have been made to clarify the nature of the channels and acupoints or to confirm the various theories related to them. If we examine the difficulties associated with studying these phenomena, we may be able to describe a

50

The Channel System: Jing Luo Theory

variety of tests, experiments, and theories that both demonstrate and clarify their nature. We have already stated that the channels and acupoints seem to be an essential component of the X-signal system. In demonstrating this we can not only demonstrate traditional theories, but describe new clinical rules and devise useful clinical procedures.

PATHWAYS OF THE TWELVE PRIMARY CHANNELS In chapter ten of the Ling Shu we find simple, concise, and very abbreviated descriptions of the pathways of the twelve primary channels. These descriptions form the basis of most later descriptions. There have always been difficulties understanding these ideas. As with many other classical discussions through the long history of Chinese medicine, numerous inconsistencies and variations arose as different ideas about their pathways, natures, and functions were added by different authors. Perhaps the most commonly cited descriptions can be found in the Shi Si Jing Fa Hui of the fourteenth century, which gives detailed, relatively clear descriptions of each channel. But if we examine modern acupuncture texts from around the world, we find variations for each of the twelve channels and many of their acupoints. Many books describe the bladder channel as having two parallel trajectories, the first one and one half cun (divisions) and the second three cun lateral to the spine. Other books describe three parallel trajectories, the third being half a cun lateral to the spine. Still other texts describe the third trajectory as being down the spine itself. There are also variations in location and order of specific acupoints. Some believe that the order of the bladder channel and its acupoints passes from the line one and one half divisions lateral to the spine (BL-11 to BL-35 at the base of the spine), to the top of the line three divisions lateral to the spine (BL-36), then down the back and the leg to BL-50. Others believe that the medial line first descends the leg to the popliteal crease then rises to the top of the lateral line on the back. How do we approach these differences to determine if one is right, or more correct, than the other? Proponents of each theory claim clinical results to support their theory. But what does this mean and how are we to evaluate these claims? In some German 1 and English2 texts we find descriptions of the abdominal pathways of the stomach and kidney channels that are more lateral than those most other texts describe. When questioning some of these authors, we found that this theory derived from a literal interpretation of some sketches from sixteenth century and early seventeenth century acupuncture texts. The Zhen Jiu Da Cheng is often cited. This text presents somewhat primitive and exaggerated representations of the pathways of these two channels. Again, the proponents of these interpretations lay claim to clinical results as support for the acceptance of their sources. We can see in the following illustrations from the Zhen Jiu Ju Ying of 1529 that the stomach channel trajectory is not shown as moving closer to the midline of the abdomen as is described by most sources. Instead, it remains more lateral, roughly on a line that passes through the nipple. Likewise, the kidney channel is shown much further lateral to the midline than is typical. Again, these pictorial trajectories have their proponents, despite the written descriptions in the same texts. The textual discussions of point location do not match the illustrations in the same book. The written descriptions place the channel trajectories closer to the midline than the representative diagrams.

The Channel System: Jing Luo Theory

51

Figure 4.1: Ancient channel trajectories of the stomach and kidney

In addition to variations of actual channel trajectories from school to school, there are many variations of acupoint location. Two illustrative examples show the scope of this problem. In China today, LU-7 is located in the small hollow on the radius, one and one half divisions proximal to the wrist crease. In Japan, it is usually located one and one half divisions proximal to the wrist crease on an imaginary line between LU-9 and LU-5, that is, between the radius and radial artery.3 Similarly, LI-2 is usually said to lie on the large intestine channel distal to the metacarpophalangeal joint. Yet others place it at the middle phalangeal joint. Again, good clinical results are claimed for either location.

Figure 4.2: Alternate locations of LU-7 & LI-2 Anyone familiar with more than one traditional view of acupuncture and moxibustion can recount similar examples. Many questions exist regarding which theory or interpretation is correct. These differences and unresolved contradictions fuel the fires of skepticism in the scientific community. Those who believe that acupuncture and East Asian medicine are simply nonsense point to these inconsistencies with glee. Such inconsistencies also have had a negative impact in the

52

The Channel System: Jing-Luo Theory

acupuncture community, where many who study acupuncture and moxibustion do not believe in the existence of the channels. They consider only the acupoints, and often not even the classical acupoints. The problem is large and difficult to resolve. We saw earlier how the requirements of scientific rigor often force the researcher to ignore precisely those ideas to which their attention should be given. These philosophical and methodological problems are exacerbated when acupuncturists posit that the channels are just a conceptual idea, perhaps only a heuristic device. The various interpretations and variations of pathways and locations are used as evidence of this. Thus, in both the West and East Asia, there is controversy as to the existence, nature, and usefulness of the channels and their acupoints. Essentially the problem becomes one of verification and research. How does one demonstrate that one theory or interpretation is valid, or that it is more valid than another? Is it possible to resolve the textual inconsistencies? This is made even more difficult because each school and tradition claims that clinical success validates its particular viewpoint. Clinical success does not guarantee the validity of a theory. It requires that we address the equally difficult problem of defining what we mean by " success." When different traditions claim success in their treatments, what independent standards do we use? The problem is further compounded by the difficulties inherent in actually measuring the channels and acupoints, of mapping them scientifically. If the channels and acupoints are indeed real, then they should have some material basis in the body. My friend the late Dr. Yoshio Nakatani of Japan, the founder of the Ryodoraku school, measured and used the electrical characteristics of the channels and acupoints, especially the source-yuan points.4 Dr. Reinhold Voll of Germany mapped the channels and acupoints electrically and diagnosed by measuring electrical properties at the terminal or jing points.5 Dr. Robert Becker of the United States has measured the electrical characteristics of the channels and acupoints.6 Dr. Li Ding Zhong of China has presented dramatic evidence for the existence of the channels through his study of dermatological diseases? He also presents evidence for the channels derived from the phenomenon of propagated sensations, a phenomenon first described in Japan in the 1950s, occurring in a small percentage of people.S In this last category, with insertion of a needle into a specific acupoint, sensitive persons can describe the trajectories of the channels based on the sensations that they experience. Many practitioners have had patients who have at least some ability to describe these propagating sensations. r--"\"W. . ......-:-r---,

Figure 4.3a: Map of propagating sensations on patient's shoulder and back.

The Channel System: Jing-Luo Theory

53

The preceding figure shows the pathways described by a blind channel-sensitive person after needling GV-14. Drs. Rokuro Fujita, Masao Maruyama, and Yoshio Manaka examined this patient. Notice the various lines over which he would consistently feel the propagating sensations. This was a particularly interesting case. GV-14 is located below C7 (cervical seven) according to one theory, below C6 (cervical six) according to another, and below T1 (thoracic one) according to yet another. The examiners took advantage of this sensitive patient's descriptions to investigate these different locations. It was found that needling any of the three locations produced the same propagations. Each was felt in three directions. However, when a large magnet was placed on the patient's shoulder close to GV-14, the different locations produced different radiations when the point was needled. The C6 location radiated only to the bladder channel; the C7 location only to the gallbladder channel; and the Tllocation only to the small intestine channel, each point producing a different directional effect.

Figure 4.3b: Differing propagating sensations following magnet placement.

When thinking about this phenomenon and these different directional effects, we reasoned that they might be related to the electromagnetic fields of the body, that small changes in the fields would change the pathways of propagation. We think that this is probably a better way to understand the phenomenon. This example makes obvious the difficulty of drawing any concrete conclusions about exact channel pathways or acupoint locations. If we study every researcher's tests and studies, we find that each researcher describes different pathways and different acupoint locations. Often these pathways and point locations are quite different from the classical descriptions. As with the classical and modern acupuncture literature, there is little consensus regarding exact trajectories, pathways, and locations. These findings only seem to add to the controversy. How can we understand these seemingly contradictory ideas and descriptions? We think it is possible to reach some acceptable understanding by considering the following: - The roles or functions of the channel system. - The probable evolution of the channel system concepts. - The probable mechanisms of observation used by the ancients who first described the channel systems. If we are able to imagine ourselves living at the time when the channel system was first being described and systematized, we may be able to gain some insight

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into what the channels were thought to be. What were the likely observations that inspired the ancient Chinese to speculate and then develop channel system theory? Perhaps coupling these speculations with simple clinical tests and demonstrations using "polarity agents," that is, working from the demonstrable channel phenomena themselves, we may be able to resolve some of the contradictions and difficulties. For staunch skeptics who question what the channels "really" are, our methodology will be unacceptable. There likely will never be a satisfactory answer for such questions, at least until the advent of an as yet unconceived measuring method. Perhaps such questions of reality are far too problematic, as they are rarely (if ever) resolved. The hidden assumptions, the manner in which the question is asked, and the methods chosen to find the answer, always color or preselect the research findings. Even the most ardent objectivists recognize that purely objective research is theoretically and practically impossible. Thus, questions of reality are rarely the terrain of the scientist.9 Often the ability to ask the correct question is as important as finding an answer.

CHANNEL SOFTWARE VERSUS HARDWARE Many authors have taken an analogy from computer science to distinguish the software of a system from its hardware. For example, Davies has suggested that there are software laws that cannot be logically derived from the underlying hardware: We are therefore led to entertain the possibility that there exist "software laws" in nature, which govern the behavior of organization, information and complexity. These laws are fundamental, in the sense that they cannot logically be derived from the underlying "hardware laws" that are the traditional subject matter of fundamental physics, but they are also compatible with those underlying laws . .. The software laws apply to emergent phenomena, inducing their appearance and controlling their form and behavior.lO

Perhaps the channels operate as software, as emergent properties of the body's hardware. A few years ago, on a trip to Paris, we had the good fortune to visit the Sorbonne museum. There, an historical collection of scientific hardware, scientific equipment and curiosities, was displayed. It was interesting to see so many different hardware devices, practically all of which are now out of date or have failed to survive. The software, the theories behind such a diversity of hardware, are neither so numerous nor so complex, but the physical outcome is sufficiently vast to fill a museum with their skeletons. Perhaps there is some similarity between this and the channels. One could see in this museum that the software has remained practically unchanged, while the hardware rapidly comes and goes. Perhaps it is not critically important to know the hardware of the channels, since treatments can be devised without that information. We can report many clinical cases where the significance of the channel software is clearly the most important information. For example, at the Kitasato Institute, Ms. Itaya treated a patient for amenorrhea. This patient had received numerous hormonal treatments that were ineffective. Physical exams showed her in good health except for the amenorrhea. She had tried various Western medical treatments during the last three years without success and was finally told by the physicians that her case was hopeless. However, we could find a very clear East Asian medical diagnosis for her condition. In this case, the channels were an essential key to successful diagnosis and treatment.

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While the hardware or mechanisms of these imbalances remain unclear, we are able to make diagnoses and perform successful treatments using just the software, the theories that are based on the unknown hardware. Such is often the case in the practical application of systems or methodologies. For example, an expert river fisherman can almost intuitively judge the best weather and river conditions and select the part of the river that will yield the best catch. Despite there being little hardware or physical evidence to support the methodology of expertise in river fishing, such expertise truly exists. Similarly, a professional baseball player is able to hit a ball that is travelling at very high speeds with incredible precision. The rate at which the ball travels is on the order of ten times faster than the speed of the nerve signals that must occur for the player to strike the ball. The hardware for such expertise is thus difficult, if not impossible, to describe. A high level of technology can be developed without any scientific foundation, as long as one has the ability to perform the appropriate input-output analysis of the observable phenomena. Expertise or knowledge of the channel software is a form of understanding the body's "blackbox."ll While we can offer no clear description of the body's hardware, we propose that it is better to examine and define the software first. This not only helps us in our quest to define the hardware, it helps us refine our clinical skills as we discover clinical rules and applications. To this end, the use of polarity agents is extremely useful for mapping operative characteristics and providing a practical body of knowledge based on simple, repeatable tests. For example, tradition teaches that channel flow begins with the lung channel at LU-1 on the pectoral muscle. It then flows down the arm to the thumb and returns from the index finger at Ll-1 as the large intestine channel, travels up the arm, shoulder and neck, to the side of the nostrils. Here it continues as the stomach channel, etc. We can take advantage of the electrical characteristics of the channels to investigate this. Using the polarity agents of zinc (-) and copper (+), we can demonstrate this circuit. If pressure pain appears on this part of the circuit, since the stream of the circuit is unidirectional, placing copper (+) upstream (close to the source/origin/beginning) and zinc(-) downstream (further from the origin), without joining the two metals, should cause any pressure pain located between the two metals to decrease or vanish. We propose this because of the addition of current flow in the direction of flow of the channels. If we reverse the zinc and copper, according to this same logic, the pressure pain should return. This is exactly what happens. This two-point contact works regardless of the distance between the points. The two metals can be placed only on the lung or large intestine channels, or as one metal on each. One metal can be on the shoulder and the other on the hand or both can be only a centimeter apart; all combinations work. The pressure pain on the circuit between the metals is increased or decreased depending only on polarity. However, pressure pain is unaffected when the metals are placed on points that are not on the channels or are on other channels.12 With this simple experiment we can begin to map the channel software.

EARLY OBSERVATIONS OF THE CHANNEL SYSTEMS When we read a classic description of the channels, we are reading the product of many years of research and practice. This is often forgotten. There was an evolution prior to the writing of the early texts, and an evolution of ideas through later and modem texts. Parts of this evolution will always remain unclear, lost in history, while other parts can be traced through reasonable conjecture, and archaeological and textual research.

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The earliest observations of the channel system were somewhat similar to the propagated sensations already described. Perhaps various ancient doctors found particularly sensitive patients, or were themselves exceptionally sensitive. They described sensations that propagated along specific routes when the body was stimulated. Wishing to document and teach their discoveries, these ancient doctors wrote books. Possibly, the readers of these books did not share the authors' sensitivity or experiences. They may have had difficulty understanding what was written because they did not share the direct observation that produced the descriptions. Thus, they understood the descriptions slightly differently, each according to their individual background and clinical experience. We can envision how diverse interpretations of a single phenomenon may have arisen. It is also worth noting that modem studies of propagated sensations reveal individual differences in the trajectories of propagation. It is likely that this was also a factor in ancient times. The phenomenon is clearly documented, but it does not provide the systematic theories we have now. It provides the foundations on which such a systematization could be constructed. This systematization probably occurred as the result of direct observations. It was, for example, commonly observed that treating a point on one part of the body produced changes at another part. The evolution of vertical or longitudinal relationships -later called the channels- probably included this variety of observation as well. Recently a manuscript titled Yin Yang Shi Yi Mai Jiu Jing (Yin yang eleven-vessel moxa treatise), dated prior to 168 BC, was excavated at the Mawangtui archeological site in China. In this text there is no mention of a twelfth channel corresponding to hand jue yin (pericardium); neither is there any reference to a three yin-three yang categorization of the channels, a five-phase categorization, or any specific acupoints. To date, this is the oldest extant written record that makes reference to the jingluo. It is believed by some to be the antecedent of the jingluo system described in the Nei Jing. The channel system used in that era was much simpler, referring more to body parts than to internal organs. Yet we cannot doubt that it was effective as a therapeutic system in its day. At least we can safely assume that its inclusion with other treasures indicates that the book was honored and revered. We cannot say conclusively that this system was the prototype of the channel systems described by later literature; however, we can imagine that at least the earliest channel system concept would include the ideas of inferior-superior, vertical body relationships, that are described by this early text. Another example of what is probably an early conceptual stage in the evolution of the channel system can be found in chapter 21 of the Su Wen. Here, only four categories are given for the channels. The back of the body is labeled as being controlled by tai yang, the front by yang ming, the lateral aspect by shao yang, and the medial aspect of the limbs by tai yin. Ling Shu chapters 10 and 15 describe the channels as a circuit: lung ~ large intestine ~

spleen fire => earth => metal => water => wood, etc., each phase is engendered by (is the child of) the previous phase in the cycle and engenders (is the mother of) the next phase in the cycle. In the restraining pattern, each phase is restrained or controlled by another phase and restrains or controls yet another phase, e.g., wood => earth => water => fire => metal => wood, etc. Diagrammatically these two are shown as:

Figure 19.1: The Engendering Cycle

Figure 19.2: The Restraining Cycle

Aside from these two, their opposites are also described, the counter-engendering and counter-restraining cycles, allowing for interaction of each phase with all others such that they completely regulate each other. Reference to these patterns is commonly made, though often they are seen as mere speculation, without physiological basis. Another important function of the five-phase theory lies in its facility for explaining various biorhythms. Early descriptions of five-phase theory focused on yearly and sixty-year patterns, examining the influences of climate and season. Later descriptions (circa 1400) focused on daily, ten-day, and sixty-day biorhythms. These descriptions are very exact and can still be found in modem literature and practice. Five-phase theory lies at the heart of the theoretical explanations of these rhythms. In this paper we will focus on the second general use that describes phase interactions: the engendering, restraining, counter-engendering, and counterrestraining patterns of the phases. In future papers we hope to explore in more detail the first and third uses of five phase theory. To construct an appropriate model for these, we have had to make the assumption that it is possible to consider all phenomena in the body categorized within one phase as representing a single united energy state. For example, the liver, gallbladder, liver and gallbladder channels, the tendons and muscles, etc. all belong to wood; the total physiological activity of all these create the wood energy state. At this level of description we use the term "energy" in a broad sense. In the discussion at the end of this paper, we speculate briefly on the possible physiological basis of this energy. Note also that the energy transfers between the phases that

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occur in the four restraining patterns, e.g., wood engenders fire, wood restrains earth, etc., have very low level energy contents. By simple addition or subtraction they neither increase nor decrease significantly the energy content of the phases. Rather, they are "information" transfers (see the discussion at the end of the paper).

ANALYSIS The patterns of interaction describe how the change of energy of a particular phase is affected by the energy changes in itself and other phases. We first will formulate precisely our assumptions, then derive an appropriate mathematical model that describes the evolution in time of the energy of each phase, using a system of five ordinary differential equations. Then we will analyze this system. The main idea is that each phase has its "normal" steady state energy. We are interested in determining under what conditions the system is stable under small perturbations, i.e., if we slightly change the energies of different phases, will the energies return to the steady states? This is important since the five phase "laws" predict that they should return to the steady states. 1) For simplicity of mathematical analysis, we assume that all five phases are identical in the sense below. 2) Denote by [ wi (t), i = 1, 2, .... , 5 ] with [ wi = wi ± 5 ] the energy of each of the five phases, considered as a function of time [ t ]. By subtracting the "normal" steady states, we can assume (without loss of generality) that all the five steady states are zero; thus [ wi (t) ] is the difference between the energy at time [ t] and the "normal" energy for a phase [ i ]. 3) We assume that when [ wi = 0, i = 1, .... , 5 ] (i.e., each phase is in the steady state), the sum of the influences on each phase is zero (i.e., the whole system is in equilibrium). 4) We assume that the rate of change in time of energy of the phase i, dwi , i = 1, .... , 5

at

is the sum of the quantities proportional to the energies of phases, j 1 j = 1, •••••1 5. More specifically, we postulate the following system of five linear ordinary differential equations: (1) dwi = awi-1 - bwi-2 - cwi- dwi+1- ewi+2 , i = 1, ..... , 5. dt To understand what system (1) says, assume for example that wi is the energy of wood. 4.1) (Engendering) The rate of change of wi(wood) is proportional to awi-1 (water), a> 0. This means that if wi-1 > 0 (the energy wi-1 of water is above the "normal") then the energy wi of wood increases; if wi-1 < 0 (the energy of water is below "normal") then the energy wi of wood decreases. 4.2) (Restraining) Similarly, the rate of change of wi (wood) is proportional to - bwi-2 (metal), i.e., if the energy wi-2 of metal is above (below) normal, the energy wi of wood decreases (increases). 4.3) wi (wood) affects itself homeostatically, proportional to - cwi. If wi > 0 it decreases itself; if wi< 0 it increases itself, c > 0. 4.4) (Counter-engendering) If wi+ 1 (fire) is above normal, it decreases wi (wood); if it is below normal it increases wi proportionally to- dwi+ 1 , d > 0.

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4.5) (Counter-restraining) If wi+2 (earth) is above (below) normal, it increases (decreases) wi (wood), proportionally to- ewi+2, e > 0. Expect a> b > e > d. The

m:~xoffulesy:r~r~r=~ :~ -e -c

-b -e

a -b

-c a

I

-d -c

This is a circular matrix [3]. The stability condition is that all eigenvalues of A should have a negative real part. The eigenvalues are [4]: (2) ~ = - c + apj - bp2j - ep3j - dp4j , j = 1, ..... , n, (3)

"-1 = "-2 = A-3 = "-4 = "-s=

p = p2vt/5 ' t = v--:r - c + ap - bp2 - ep3 - dp4 , - c + ap 2 - bp4 - ep - dp3 , - c + ap3 - bp - ep 4 - dp2 , - c + ap 4 - bp3 - ep2 - dp , -c+a-b-e-d.

Note that ReA-1 = ReA-4 ReA-2 = ReA-3 . Denote Rep = Rep4 = :os 27t/5 = .309 = y> 0, Rep2 = Rep3 =cos 47t/5 = -.809 = -P < 0, From ReA-1 , ReA-2 , ReA-5 < 0, we have: (4) { - c + (a-d) y+ (b +e) p < 0. - c - ( a - d ) p - ( b + e ) y < 0. - c + ( a - d ) - ( b + e ) < 0. Under the assumption a> d the system (4) reduces to the first and third equations: (5) {

(a-d) y + ( b +e) P < c, - a - d - ( b + e ) < c.

Denote a-d= x, b + e = y. Then (5) is satisfied for (x,y) in the region R.

y .::::

1.24 c l+P 1-y ) ( --C --C r+P 'y+P

-

(1.53 c, .57 C)

R

c

X

Figure 19.3 This tells us for which values of the parameters the zero steady state of the system (1) is stable, in particular, if c = 0 (i.e., there is no homeostatic effect of a phase on itself), then it is always unstable.

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DISCUSSION Perhaps the most significant theoretical aspect of the above model concerns the assumption that the energy transferred between the phases is of a qualitative, informational nature and not a quantitative physiological nature. The various control parameters- engendering (a), restraining (b), counter-engendering (d) and counter-restraining (e)- are concerned solely with physiological regulation and not physiological process or exchange. As the model evolved, we found that were the parameters of a physiological and not an informational nature, i.e., by simple addition or subtraction were they to increase or decrease the energy content of the phase, the system would always break down. We thus concluded that they must be informational. This outcome resolves some apparent conflicts between different schools of thought in acupuncture. Schools adhering to the descriptions of organ theory (zang-Ju theory) as the sole basis of acupuncture have always found that the fivephase parameters (a, b, d, and e) are unable to describe the physiological functions and interactions of the zang-fu. However, when we take the view that these parameters are concerned solely with the interactive regulation of the zang-fu, the channels, and the related phase-sets, and are not the physiologic interactions themselves, then the conflict is resolved. Clinically this implies, at the very least, two different types of acupuncture practice. One is concerned solely with the regulation of the control parameters. Since these are of an informational nature, i.e., they have tiny energy content, they require only tiny stimulation to achieve this regulation. This supposition is supported both by clinical practice and results and clinical research and investigations [5]. The second type of practice is more explicitly concerned with the physiological activities of the zang-Ju, and thus concentrates on the physiological energies themselves. Consequently treatment tends to use stronger stimulation to achieve such effects. This, too, is supported by clinical practice and results and clinical research. The method of treatment seems closely tied to the theoretical basis of the treatment. In a future work we hope to investigate these relationships and differences. For the model to create a stable interaction between the phases, we found it necessary to add a fifth parameter, (c). This is the "intra-phase homeostatic" parameter. Increase or decrease of this only speeds up or slows down the return to normal. We hope to investigate this parameter in further papers. It is possible that it relates, at least in part, to the "ten stern" expanded model of the five phases [6]. To date our attempts to apply this model in treatment have found that it fails to adequately explain the following: (i). How do the parameters a, b, d, and e actually increase or decrease physiological activity within a phase and thus either increase or decrease the energy state of the phase? (ii). This model is a linear approximation, but in practice we will need nonlinear models to explain non-linear phenomena. For example, when a phase is vacuous (vacant, deficient, depleted), we can interpret this as an imbalance of a parameter that changes and resets the steady state of the phase. In such a case, traditional theory tells us to "supplement the mother." For a wood vacuity, we therefore supplement water. This improves the "child" phase, wood, while the "mother" phase, water, returns to normal. This sequence of events must be interpreted as a non-linear phenomenon, requiring changes in parameters, energy states and steady states.

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Appendix Five: A Mathematical Model for the Five Phases

It is necessary to expand the model to include more parameters. This will be the basis for a further paper. We think for example that adding a sixth parameter, cl, is necessary. If it is caused to increase, it will increase the physiologic activity and thus the energy state of its related phase. If it decreases, it decreases physiologic activity and thus the energy state of the phase. Introduction of such a parameter allows for an explanation of how the shu acupoints, the five-phase acupoints on each channel, might bring about their specific effects. It also allows for an explanation of the yuan (source) acupoints and their effects. If it is necessary to introduce this parameter, then it is possible that we have uncovered a necessary relationship between the five phases and the source-triple burner/pericardium functions. Based on translations of original texts, arguments have been made that such a necessary relationship exists [7]. In a future work, we hope to examine these relationships. Since five-phase treatments typically use the phase acupoints on each channel and each channel has a phasal correspondence, then it will be necessary in future work to develop a model of the channel systems, to be able to fully explain how treatments work. Our next paper will focus on this problem, as the current model is clearly inadequate to deal with it. It may also be necessary to develop a ten-stem model as part of the channel model to explain some of the relationships. A final word on the biological basis of these descriptions is necessary. In research and in practical utilization of the phase acupoints on the channels, it is clear that they have the phasal characteristics described by the traditional literature. The methods by which these acupoints have been explored suggests that the control parameters they affect - the flow of interactive regulatory information or signals - have electrical, magnetic, electromagnetic, and possibly other characteristics. Information may be encoded by frequency, wavelength, amplitude and other properties [8]. There is ample evidence of the existence and role of weak electric currents, ionic currents, electric fields, magnetic fields, electromagnetic radiation, coherent light waves, etc., as the carriers of biological information in the body [9]. In future works, as we develop the model, we will test it using computers to simulate the development of a disease, its diagnosis and treatment, and make measurements on the body to see if we find or measure the predicted outcomes. Measurements must be of specific events and will probably be of electrical parameters like voltage and resistance, since adequate equipment exists for this. It is our hope that by evolving a mathematical model that is tested at each step, we will be able to demonstrate that theories from acupuncture and Chinese traditional medicine have a firm scientific and biological basis. Further, we hope that the model will have practical applications that enable acupuncturists to take advantage of these theories.

GLOSSARY Five phases: This concept is sometimes called the five elements. The term refers not to concrete things, rather to methods of categorizing and describing relationships and correspondences in nature. They have superficial similarity to the Greek four elements. Channels: This refers to pathways or trajectories of qi energy flow in the body. There are a number of different channels that criss-cross the body surface and interior. The major channels have relationships to specific internal organs. As yet the channels have not been clearly described anatomically, but have been measured electrically and observed using other specific techniques.

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Zang-fu: These are the internal organs. However, the Chinese reference to the zang organ, xin (heart) refers to more than the simple physical structure, but involves a series of other functions as well. The "triple burner" and "pericardium" are two unusual zang-fu that have unclear anatomical correspondences and phasal correspondences. Acupoints: These are discrete sites at the body surface, usually located on the channel trajectories. They are the points into which needles are usually inserted to produce the healing effects of acupuncture. Like the channels or meridians, these have been measured electrically.

NOTES [1] Dr. Yoshio Manaka is one such practitioner. [2] See Matsumoto, K. and S. Birch, Five Elements and Ten Stems, Brookline, MA: Paradigm Publications, 1983. [3] Lancaster, B., Theory of Matrices, New York: Academic Press, 1969.

[4]Ibid. [5] See for example: Matsumoto, K. and S. Birch, Five Elements and Ten Stems; Manaka, Y. and K. Itaya, "Acupuncture as Intervention in the Biological Information System," an address given at the annual assembly of the Japan Meridian Treatment Association, Tokyo, March 1986; and Manaka, Y., K. Itaya and S. Birch, Chasing the Dragon's Tail, Brookline, MA: Paradigm Publications, 1995. [6] See Matsumoto, K. and S. Birch, Five Elements and Ten Stems for a description of this. [7] See Matsumoto, K. and S. Birch, Five Elements and Ten Stems, and Matsumoto, K. and S. Birch, Hara Diagnosis: Reflections on the Sea, Brookline, MA: Paradigm Publications, 1988. [8] See Manaka, Y. and K. Itaya, "Acupuncture as Intervention in the Biological Information System;" Manaka, Y. and K. Itaya, "Biasology applied in acupuncture," unpublished manuscript, 1987; Manaka, Y., K. Itaya, and S. Birch, Chasing the Dragon's Tail; and Paul Nogier, From Auriculotherapy to Auriculomedicine, St. Ruffine, France: Maisonneuve, 1983. [9] As examples see the following: Burr, H.S., The Fields of Life, New York: Ballantine Books, 1972; Becker, R.O. and G. Selden, The Body Electric, New York: William Morrow, 1985; Taubes, G., "An Electrifying Possibility," Discover, April 1986; Sedlak, W., Bioelektronika 1967-1977 with English summaries, Poland Instytut: Wyadawniczy Pax, 1979; Callahan, P., Tuning into Nature, Old Greenwich, CT: Devin-Adair, 1975.

TOWARDS 1HE DEVELOPMENT OF A MA1HEMATICAL MODEL FOR ACUPUNCfURE CHANNELs* *FIRST PUBLISHED IN ACUP. &ELEC. THER.RES.[NT.fOUR

14, PP 217-226, 1989

[1] MARK J. FRIEDMAN, PH.D., ASSOC. PROFESSOR, DEPT OF MATHEMATICS AND STATISTICS, UNIV. OF ALABAMA AT HUNTSVILLE, ALABAMA, 35899, [2] STEPHEN BIRCH, LIC.AC., B.A., SOCIETY FOR ACUPUNCTURE RESEARCH, P.O. Box 33, NEW TOWN BRANCH, BOSTON, MA. 02258, [3] WILLIAM A. TILLER, PH.D., PROFESSOR DEPT OF MATERIAL SCIENCE & ENGINEERING, STANFORD UNIVERSITY, STANFORD, CALIFORNIA, 94305.

ABSTRACT Traditional concepts of classical acupuncture and Chinese medicine come from a culture which is very different from ours, and there have been considerable problems in their accurate presentation. Our approach is to attempt the development of a mathematical language that links these traditional concepts theoretically to models that can be tested experimentally.

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We will first review some of Manaka's findings, confirmed also by our results, having to do with low-intensity stimuli. In particular, Manaka applied polarized agents such as Cu (+) and Zn (-) to non-acupuncture points on a channel and to the so-called "mother" and "child" points on a channel. In both cases he observed the pressure-pain reaction which increased for one orientation of Cu and Zn on the channel and decreased for the opposite orientation. Note that in the case of mother and child points the observed reaction was in agreement with the "five phase" (five element) theory. Also, in the case of the mother and child points, the effect usually lasted considerably longer than in the case of non-acupuncture points on a channel. We will describe several case histories supporting the latter observation. We have interpreted Manaka's clinical findings in terms of a three-level model: 1) a low-intensity signalling system 2) a channel system 3) an anatomophysiological system Taking into account the connection between Manaka's results and skin electrical measurements by some electrodermal diagnostic instruments such as Motoyama' s AMI, we discuss some equivalent electric circuits for a single channel and relate them to the nervous system response. In particular, an electrical circuit model similar to a synapse membrane with two ionic channels (note that we are not talking here about real membranes which have more than two channels) seems especially useful when we try to explain Manaka's clinical results and Motoyama's results on the velocity of propagation of electrical impulses along channels. We develop a mathematical model in the form of a linear five-dimensional dynamic system of the five-phase laws such as the engendering cycle, restraining cycle, etc., in the case of a single channel. We connect this model with the membrane type model above by assuming a simple mass action law (which says that the closed pores in a channel open at a rate proportional to their number and to the input signal) for the dependence of the conductances in the ionic channels on inputs. This combined model is used to describe the development of a disease and its treatment according to the "five phase" theory. Here we interpret "disease" as a blockage in a channel, while a treatment initiates the unblocking process.

INTRODUCTION There have been substantial problems in the accurate presentation of traditional concepts from acupuncture and Chinese medicine. For too long poor philological and scholarly standards have been applied and it is only recently that appropriate standards have begun to appear (see Unschuld) [1 & 2]. This has been compounded by a tendency to try to westernize these concepts by reducing them to concepts that typically do not address the traditional theoretical concepts themselves. This is like trying to relate concepts from one culture to concepts in another culture without having found a language that bridges the two cultures. The result is a mass of contradictory information that often seems irreconcilable. In a simple attempt that pays attention to the traditional concepts themselves, the authors propose the development of a mathematical language that tries to link these concepts theoretically to models that can be experimentally tested. To our knowledge, this is the first attempt to build such a bridge and should be recognized as being only a working model in its infancy. Our use of mathematics here is in the spirit of the development of dynamic system models of complex neural phenomena (see e.g., Carpenter and Grossberg [3]). The mathematical models we derive here draw from three sources:

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(i) knowledge (very limited) of the underlying physical mechanisms (ii) observed clinical phenomena (iii) the translation of the traditional theoretical concepts into their minimal realizations as mathematical laws. Experimental evidence supports a connection between the results of classical acupuncture diagnostic procedures and the results of some electrodermal diagnostic instruments such as Motoyama's AMI and Nakatani's Neurometer. Such measurements lead to simple electrical equivalent circuits of the skin discussed recently in Tiller [4]. In section 2 we first review these circuits and then try to relate them to clinical practice by examining the clinical findings and clinical results of Yoshio Manaka, which investigate the validity and applicability of certain traditional ideas. Exploration of these clinical findings and results show the need to extend the simple model to be able to explain the observed clinical phenomena. Such an extension is explored mathematically with suggestions for further clinical experiments to establish its validity and further extension. In particular, Manaka applied copper and zinc to non-acupuncture points on a channel and to the "five phase" (five element) points and observed the channel responses. To explain his results we introduce an electric circuit model similar to synapse membranes with two ionic channels. Section 3 contains case histories that support the mathematical model developed in section 2. In section 4 we assume an interpretation of disease as a blockage in a channel and assume that treatment initiates an unblocking process. We hypothesize an appropriate dependence of the conductances in ionic channels on inputs and consider a simple dynamic systems model to account for the development of disease and its treatment according to the five-phase laws. The channel is an important concept in acupuncture. It is described as having several functions, probably the most important of which is the distribution of a kind of energy, called qi. The treatment loci of acupuncture lie mostly on these channels. Considerable efforts have been made to understand, measure, and demonstrate the existence of the channels. Measurements made by many researchers have shown that the channels have electrical characteristics (see e.g., [4] and especially [5], which has an extensive bibliography). A certain number of people are ultra-sensitive and are able to describe the movement of sensations following insertions of needles into the channels. These propagated sensations tend to follow channel pathways and have been investigated extensively in China and elsewhere (see e.g., [6]). Dermatological diseases have sometimes been observed to produce lesions and eruptions that lie along the channel trajectories (see e.g., [7]). Attempts have been made to visualize the channels by injecting radioactive isotopes and observing their migrations with a scintillation camera (see e.g., [8]). More recently, using a "bidigital 0-ring test," Omura has provided striking evidence for the existence of "meridian-like networks," which show some correspondence to the channel systems (see e.g., [9]). While the exact nature of these channels is not clear, there is more than clinical evidence to support the premise that they exist.

EQUIVALENT ELECTRICAL CIRCUITS FOR A SINGLE CHANNEL The simplest electrical equivalent circuit corresponding to a single channel used for skin measurement analyzed in Tiller [4] has the form:

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Appendix Five: A Mathematical Model for the Five Phases

R,

c Figure 19.4

Here R 2 and C correspond to the epidermic layer of the skin and Rt corresponds to the dermic layer. Note that the parameters of the circuit depend in general on the voltage. The Motoyama AMI instrument applies a DC potential of V 0 = 3 volts between a number of channel terminal points and a large indifferent electrode on the wrist and measures the short-time current response (1-100 microsec). In what follows we use the term channel as the corresponding electrical circuit pathway. Clinical evidence of Manaka [12] and others suggests the possibility that the initial electric current BP = V0 I Rt is a parameter corresponding to traditional acupuncture diagnostic measurements (such as radial pulse palpation, abdominal palpation, visual inspection, etc.), though we are not aware of rigorous research that confirms this suggestion. More precisely, for a particular channel, a high BP compared to the average taken over all the channels corresponds to repletion. In traditional terms, repletion (shi) is a condition of too much qi from various causes. A low BP compared to this average corresponds to vacuity. In traditional terms, vacuity (xu) is a condition of insufficient qi from various causes. Here, BP refers to the initial current response at time t = 0 before any polarization has occurred. Because of the known occurrence of circadian rhythms (see e.g. Manaka [12]), where current readings have been found to fluctuate according to the time of day, we feel that further experimental evaluation is required to validate these definitions. The acupuncture points are known to have a positive potential of several millivolts (see e.g., Tiller [4] and the discussion there). To account for this we add a battery E to the circuit of Figure 19.4.

-cJ---1 R, c Figure 19.5

Manaka' s clinical practice and experimental research in acupuncture has led him to suggest the existence of a biological signalling system which has the following characteristics: 1. The biological system works at the level of low intensity signals and responds to low-strength stimuli. 2. The biological system is able to detect and discriminate both internal and external changes, and plays a role in regulating the body by transmitting this information to other parts of the system. 3. As part of the signalling system, certain components of traditional acupuncture practice can be used clinically to regulate the body as indicated below. It was suggested that this signalling system has embryological and evolutionary roots and functioned to regulate the body prior to the development of the neurological, endocrinological, etc. systems. Generally, acupuncture activates both the

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simple signalling system and the more advanced regulatory systems. In such cases, both effects occur together and need to be clinically discriminated since the effects of the signalling system are generally masked by the more evident anatomophysiological system effects. The following diagram illustrates the interaction of the signalling system, our electrical model of the channel system and the anatomophysiological system: ~

Ievetone

~signaling

system

t ~level two ~channeling

system

l

~level three ~anatamophysiologic

level Figure 19.6

The channel system at level two, the electrical circuits in our model, interface between the signalling system at level one and the anatomophysiological system of level three. Regulation at level one produces lasting changes at level two and level three. Most forms of acupuncture work at levels one through three, but only showing the clearer and more easily measured responses from level three. Working from the premise that traditional concepts function at level one, Manaka began exploring the properties of the signalling system to see if this were so. His experiments utilized tiny small-intensity stimuli such as the application of copper and zinc plates, north and south poles of a magnet, and colors in the form of light and ink to acupoints and channels. The use of such polarized agents, in particular, allow for observation of their repeatable and reversible effects [10 & 11]. Assessment of these effects was made through observation of pressure pain and muscle tonus at acupoints on the channels investigated and on related reflex points. If the application is favorable to the channel under investigation, pressure pain and muscle tonus will decrease. If unfavorable, pressure pain and muscle tonus will increase. We have repeated his simple tests and experiments and have obtained the same results. According to traditional theory the channel qi flows in a particular direction. In an effort to relate this concept to the electrical model of the channel and to determine if there is an electric current flowing in one direction, he applied copper and zinc plates to non-acupuncture points on a channel and observed the channel responses. For example, for pressure pain and tension at right LI-4, on the flesh in the center of the web between the first and second metacarpals, placing copper upstream and zinc downstream, proximal to the wrist on the large intestine channel, decreases these reactions. Reversing the copper and zinc causes the reactions to return. Epidermis

Dermis

Figure 19.7

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Appendix Five: A Mathematical Model for the Five Phases

Manaka interprets his findings as describing a current flow in the channel which agrees with the traditional description of the flow of qi. In our electrical model, high BP relates to repletion and low BP to vacuity of the channel. However, it is known that pressure pain can arise from both repletion and vacuity (in the traditional sense of these terms). From a simple electrochemical viewpoint, copper is electropositive relative to zinc so that the application of copper upstream and zinc downstream should increase BP. Hence we assume that this adds a voltage and thus is able to describe what happens in the case of vacuity. But in the case where BP is already high, repletion-pressure pain should only increase when we do this. However for this case, clinically the pressure pain decreases, which would indicate a contradiction to our model. Consider next two possible mechanisms of the observed phenomena. The first is that the pressurepain response arises from an influence of the treatment on the neural response in the vicinity of a particular point. The chain of effects for this would be as follows: (i) surface treatment leading to (ii) changes in the local channel that ultimately manifest as electrical changes in the equivalent circuit which lead to (iii) electrolyte and voltage changes in the vicinity of the key neural channels leading to (iv) excitatory or inhibitory response in the neural fibers leading to (v) pressure pain response at the point. The second possibility is that we need to change the channel model, specifically to change R by a circuit similar to one that describes the excitatory and inhibitory responses of a neural fiber. In both possibilities we choose the same model to resolve the contradiction. Release of pressure pain from repletion or vacuity can be explained in either case by the effect of stimulation on the inhibitory and/ or excitatory channels of either the neural membrane, the equivalent channel channels or possibly both. In the first case, where treatment influences the two channels of the neural fibers, the effects on the pressure pain are relatively straightforward. In the second case where treatment influences the two pathways of the channel to effect pressure pain changes, the following are evidence in support of this model: a) pressure pain responses do not arise solely from neurological causes and therefore do not necessarily require a model of the neurological effects (see e.g., Melzack [13]). b) Motoyama's results regarding the velocity of qi support this model (see page 75 especially of [14]). He found the velocity of propagation of electrical impulses along the channels to be in the range 4 em/ sec - 50 em/ sec, which is considerably smaller than the velocity of propagation of nervous impulses which are in the range 50 em/sec-100m/sec. It appears that the propagating impulses measured by Motoyama are travelling waves; the mathematical equations which have as their solution, travelling waves, are of the form similar to equation (1) below. We therefore feel justified in the use of this model and equation (1) for the channel. c) our analysis below shows that the use of this two ionic channel model for the channel is able to resolve the above contradiction and describe qualitatively many other phenomena. To be specific, assume that a channel is described by the equation of the type used in the neurophysiological model for synapse membranes with two ionic channels: (1) C0 ~; = (v+ - v) g+ + (v- - v) g- , where v+ and v- are excitatory and inhibitory saturation points, respectively: v+ > v-; g+ > 0 and g- > 0 are the corresponding conductances of the two ionic channels, while C 0 is the

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capacitance which we can assume to be unity for simplicity. Thus, depending on the values of g+ and g-, v can take any value between v+ and v-, which we interpret as being related to the most replete and most vacuous states of the channel, correspondingly. When the channel becomes vacuous, let us presume that the resistance of the excitatory channel becomes large (the excitatory channel closes) so that g+ becomes small and v+ is close to v-; i.e., we have blockage in the excitatory channel. Similarly, if g- becomes very small, we presume that it is due to the channel being replete and vis close to v+. This we interpret as blockage of the inhibitory channel (the inhibitory channel closes). Thus for the case of copper and zinc application as indicated in figure 19.7, the homeostatic effect of reduction of the pressure pain can be explained as follows:

In the case of vacuity, g+ is increased which makes the channel more replete. In the case of repletion, g- is increased so that the channel becomes more vacuous. These simple copper and zinc tests developed by Manaka appear to demonstrate that the channels have direction of flow. The north and south pole magnets of 600-800 gauss strength have also been used to check channel flow and the results are essentially the same as found for copper and zinc. The pressure pain responses are qualitatively similar when the north pole replaces the copper and the south pole replaces the zinc. Omura [15] has shown that low-energy signals can change body musculature, but they cannot create such changes by introducing voltage to neuronal membranes. Low-energy signals cannot create a sufficient voltage to cause nerve impulses. Our model describes such signals as effecting changes in conductances and not voltages. This is similar to the negative resistance circuit suggested by Omura [15] as a possible mechanism of the above effects. These experiments have so far used non-acupuncture points on a channel. Next Manaka applied these same polarities to certain acupoints, in particular the "mother" or supplementing (tonifying) and "child" or draining (dispersing) points [10 & 11]. These acupoints are important in traditional practice. Their names derive from their association with the wu xing (five phases). We have done some exploration of the five-phase model mathematically, and formulated mathematical models which match traditional descriptions of their interactions [16]. Looking only at the interaction of the supplementing and draining points, we see that they can be modeled according to the five-phase model by the following equation, which is a simplification of equation (9) below: dsi = asj-l - dsj+l dt

Here sj is the amount of stimulation of the j-th point on the channel under investigation where this point belongs to the same phase as the channel and a > 0, d > 0 are coefficients. sj-1 is the amount of stimulation of the supplementing ("mother") phase. Accoraing to traditional concepts, we treat the mother in cases of vacuity. s·+1 is the amount of stimulation of the draining ("child") phase. According to lraditional concepts we treat the child in cases of repletion (excess). Note that Sj-1 has a positive value and sj+1 a negative value. We assume that stimulation of the channel is proportional to sj. Manaka observed polarity-dependent reversible changes associated with these points. Repeating his experiments, we have been able to confirm his findings. Placing copper to the mother point and zinc to the child point reduces pressure pain on the channel or at associated channel points. Reversing these so that zinc is on the mother points with copper on the child points causes the pressure pain to

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return. Replacing the copper with the north pole of a magnet and zinc with the south pole has the same effect on the pressure pain. In general, applying a positive electrical polarity to the mother point and negative to the child point has the same effects. Thus other polarity agents such as Manaka's ion-pumping cords (I.P.) can be used to treat these points with the same effects. The ion-pumping cord is essentially a wire with a germanium or silicone diode in it. It has clips on either end for attachment to needles (see Manaka [11 & 17]). It allows for unidirectional flow of current from the black to the red clip. Thus the black clip is negative and the red positive. Clinical usefulness of the ion-pumping cords can be seen in the case histories below. Note that they are used with great efficacy on the "extraordinary vessels" as well as on the channels. The following is a clinical demonstration of the applications of these various polarity agents to mother and child points. For pressure pain at KI-16, located approximately one centimeter on either side of the navel and associated with the kidney channel on which it lies, the following results are obtained using polarity agents on the KI-7, the mother, and on KI-1, the child points: Agent

Point

Agent

Point

Pressure Pain

copper(+)

Kl-7

zinc(-)

KI-1

KI-16 decrease

zinc(-)

KI-7

copper(+)

Kl-1

KI-16 increase

north(+)

south(-)

KI-1

KI-16 decrease

south(-)

KI-7 KI-7

north(+)

KI-1

KI-16 increase

I.P. red(+)

KI-7

I.P.black (-)

Kl-1

KI-16 decrease

I.P.black (-)

KI-7

I.P.red (+)

KI-1

KI-16 increase

These observations can be explained using the above model of the channel. The positive agent applied to the mother point and the negative agent applied to the child point opens the ionic channel pores as described above. In cases of repletion, this opens the inhibitory channel pores which will improve current flow through the channel and release pressure pain. In cases of vacuity, this opens the excitatory channel pores which will improve current flow through the channel and release pressure pain. Reversing the polarity agents closes the pores, reversing the changes in current flow and causing the pressure pain to return. These effects of the polarity applications to the mother and child points can be seen in the phase model equation above. (See section 4 for a more detailed mathematical model of this.) It is also important to notice that in eight out of twelve of the channels, the order of application of the polarities to the mother and child points is the reverse of that when applied to non-acupuncture points on a channel. In this latter case, we have postulated that part of the effect is due to the addition of voltage to the circuit, but in the former, since in most of the applications the polarity order is reversed, the action of the polarity agents on the mother and child points must be other than simple addition of voltage to the circuit. The mother and child points must have special properties not directly related to the flow of current in the channels. They regulate the channels by increasing or decreasing conductances (opening or closing the ionic channel pores). This and other of Manaka's research- for example, application of colored light and ink to these acupoints [11, 18 & 19] - supports the interpretation that these categories of acupoints do correlate to what the Chinese called the five phases. In our model their total interaction serves to regulate channel conductance. However, more rigorous clinical research is required to investigate this.

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An important point to notice in the above experiments is that in the first clinical demonstration, when applying copper and zinc to non-acupuncture points on a channel, _the effects are shortlasting. We postulate that their effects occur partially through addmg voltage to the channel and partially by opening the channel pores. Once the voltage is removed, the channel returns to its original state. In our model of Manaka's ideas above, this works at level two. We think though that this requires experimental confirmation. Applying polarities to the mother and child points works primarily at level one by changing the conductance of the channels and thus has longer lasting effects than in the other case. Rigorous experiments are required to verify this, but it at least has clinical confirmation. Manaka takes advantage of these changes clinically by applying I.P. to the mother-child points of the channels found to be problematic by his methods of diagnosis. These involve palpation of pressure pain and tension, use of the Omura hi-digital 0-ring test, pulse palpation, visual inspection, etc. Our own clinical utilization of these ideas shows their clinical application. This can be seen in the following case histories taken from Manaka and our own case loads. These case histories are essentially anecdotal, intended only to illustrate that long-term effects can be obtained with these treatments, as our model predicts. Until now, with the development of a model to describe these clinical concepts, we have had no need to do rigorous clinical studies. We recognize the need for such studies. We also recognize that our model is only for application to a single channel. Clinical reality is more complex than this. Actual treatment in these case histories is applied to two channels, often with supplementary points. Further, in the first case study, the extraordinary vessels were used on the first visit. We include this to illustrate the clinical effectiveness of the ion-pumping cords. In the future we will develop models for all the channels and their various interactions, including the extraordinary vessels. Experimental protocol requires us to start with the simple models and build on these. CASE STUDIES Case One: Female, age 53 Main complaints: Severe lumbar pain and pain of the right upper arm and shoulder. History: These problems were of nine years duration. The patient had tried the following therapies unsuccessfully during this time: traction of the spine; wearing a support brace while taking pain medications; surgery for a herniated disc; and traditional herbal therapy for one year. She was now pessimistic and depressed about her condition. Diagnostic findings: Dark facial color with pigmentation of the skin on the face and over areas of the upper back and chest. Pressure pain and tension in the right subcostal and lower left quadrant regions of the abdomen. Positive 0-ring tests at right LR-14, left ST-27, and CV-4. Tension and swelling at right BL-18. Weakness of the left radial pulse, especially in the second position at the radial notch. Poor flexion of the lumbar region. Poor flexion of the legs. Pain with abduction and rotation of the right arm. Diagnosis in this case was a problem of the liver channel. Treatment: On this first visit we used shallowly inserted needles with I.P. on the extraordinary vessels at right PC-6, SP-4 and left TB-5, GB-41 for fifteen minutes. This released the abdominal reactions and improved the 0-ring tests. Hashimoto's extension exercise for the leg was applied three times. Subsequent flexion of the legs and lumbar region showed great improvement with considerable improvement in the lumbar pain.

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At the second visit seven days later, the patient's range of lumbar flexion was still at the improved level and the patient reported having had almost no lumbar pain. However there had been no real improvement of the pain in the right upper arm and shoulder. Diagnosis revealed a slightly different pattern of abdominal reactions. Pressure pain and tension was found in the right subcostal region and to the left of the navel focusing around ST-26. Positive 0-ring tests were found at right LR-14, left ST-26 and CV-4. Diagnosis in this case was of the liver and small intestine channels. Treatment involved the use of shallowly inserted needles with J.P. to the mother and child points of these two channels for fifteen minutes in the following pattern:

right SI-3 red - SI-8 black left LR-2 black- LR-8 red

This released the abdominal reactions and improved the 0-ring tests. Range of motion of the right arm was examined. Abduction and rotation showed improvement with greatly reduced pain. Associated back points BL-18 and BL-27 were then needled and warmed with moxa to reinforce the J.P. treatment. The patient was then sent home with recommendations for dietary changes and instructions not to worry about her problems since they had responded so well to treatment. On subsequent visits over the next few weeks, the lumbar and arm and shoulder pain did not return.

Case 2: Male, age 38. Main complaints: Reiter's syndrome with arthritic pain and poor mobility of the spine and both hips joints. History: The problems began five years before with an acute onset of arthritis in the left hip joint only days after an attack of urethritis and conjunctivitis. Indomethacin and aspirin were used to treat this. Three and a half years later, the spine began showing signs of arthritis with pain, stiffness and poor mobility. 600 mg per day of Clinoril was then used in place of the previous medications with some success and partial relief of symptoms. But in the last few weeks the patient had suffered a worsening of the condition with increased severity and frequency of pain and signs that it had started in the right hip joint. The patient was sleeping very badly. He was unable to lie on his back without muscle spasms and great pain. This disturbed his sleep considerably. Diagnostic findings: The musculature of the upper body and back was swollen and tight with pressure pain in the cervical, thoracic, and lumbar regions. Pressure pain and tension was found in the right subcostal region of the abdomen. But more severe pressure pain was found at left LU-1 and at both Kl-11. Positive 0-ring tests showed at left LU-1 and both KI-11. Weakness was found in the right radial pulse at the cun position and left radial pulse at the chi position. Poor mobility of the spine and hip joints was found. Diagnosis was of the lung and bladder channels. Treatment: We applied shallowly inserted needles with J.P. to the mother and child points of the left lung channel and the bladder channel for fifteen minutes in the following pattern: left LU-5 black- LU-9 red left BL-65 black - BL-67 red The patient, lying supine with knees raised, reported a relaxing of the back muscles. The abdominal reactions and 0-ring tests improved. Range of motion of the spine was examined. The patient had greatly increased range of motion and reported a significant reduction in pain and stiffness. Needles were then inserted to BL-18

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and BL-28 and warmed with moxa. Hashimoto's sotai leg extension exercise was applied three times. Hinaishin (subcutaneous needles) were then applied to ear points for the spine and hips. One week later, the patient reported having maintained the improvements in the spine and having been able to sleep on his back with no discomfort or spasm. Treatment continued successfully over the next few weeks with improvement in the hips and a slow reduction of Clinoril until zero intake was achieved. Except for minor flare ups requiring further treatment over the last two years, this patient has maintained these improvements and now is able to lead a normal, active life.

Case 3: Female, age 75 Main complaints: Pain, stiffness and restricted motion of the left elbow, wrist and fingers following a lower left humeral fracture ten months before. Right sided sciatica with ankle pain. History: Following the injury a cast was applied. After removal of the cast, physical therapy was given twice a week for six months. During this time the patient put on weight, which irritated an old sciatic problem on the right side with pain also at the ankle. Diagnostic findings: The left arm could not be abducted beyond shoulder level. The left hand had very poor grip, and the left wrist had restricted rotation. Swelling and pressure pain was noted on the left triple burner channel from elbow to wrist. The patient was obese, and the musculature of the lumbar region was swollen and tight. Pressure pain and tension was found in the right subcostal region of the abdomen with pressure pain and tension at right ST-25 and GB-26. The right radial pulse was weaker than the left radial pulse, especially at the middle position. Diagnosis was of the spleen and triple burner channels. Treatment: We applied shallowly inserted needles and I.P. to the mother and child points of the right spleen and triple burner channels for fifteen minutes in the following pattern: right SP-2 red- SP-5 black right TB-3 red - TB-10 black The abdominal reactions improved. Abduction of the left arm was tested showing some improvement. The wrist rotation also showed some improvement. Two hinaishin were inserted to the Korean arm reflex points on the left fourth finger. Further hinaishin were placed at left LI-14 and in the right ear at the ankle and sciatic points. Finally needles were shallowly inserted at right GB-39 and GB-41 for five minutes. Abduction and rotation were retested showing further improvements. Upon stepping off the treatment bed, the patient reported almost no sciatic pain with only a little discomfort at the right ankle. One week later abduction and rotation of the left arm was still improved though some pain persisted. The sciatica had improved to a dull pain in the right buttock.

In these case studies, we can see long-term changes resulting from treatment. Our model predicted that regulation at level one should produce lasting effects. We think that this is at least demonstrated in these case studies. Below are more developments of the mathematical model which describe a possible mechanism for these treatments. Rigorous experiments will be required to validate the model.

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A MATHEMATICAL MODEL FOR THE FIVE PHASE LAWS IN THE CASE OF A SINGLE CHANNEL We consider the effects of different signals on the excitatory conductance g+ (for g- the analysis is similar). We use a simple mass action law. To be specific, assume that (1) describes a wood (liver) channel. Let T 1 be a signal leading to vacuity of the liver channel, i.e., decreasing g+, say, due to emotional and dietary factors, acting for a long time (i.e., several years) from time to to t1. At time t1 the diet was changed and treatment using needles, electrical polarities or light (according to the five phase laws) was administered for a short time from t1 to t2 by a signal T2. We thus have: (2)

(3)

T 1 (t)

=

{

0. const, t 0 t

{

0.

t < tl• s t2•

T2 = const, t1

s

0,

> tz.

t

t

The simplest mass action law is defined by: (4) gg+ = ( H + JT2 (t) ) ( g 0 - g+) - JT1 (t) g+ , t ~ t 0 , dt Where go is the maximal number of open pores (when T1 (t) = 0). Equation (4) says that closed pores, which number g 0 - g+ , open at a rate H + JT2 (t) (when T 2 (t) = 0 then the rate is H); and that the signal T1 (t) closes open pores, which number g+ at a rate J. We also assume that at timet= t0 all pores are open, i.e., no blockages: (5) g+ = go Solving (4), (5) for different time intervals gives: (6)

g+ (t) = _!L g 0, H+JT1 for timet "long enough";

• t0 ) e -H (t- t2), t ~ t2 .

s

t

s

t2;

Equation (6) shows that the excitation channel of the liver channel is now partially blocked (the conductance g decreased). Equation (7) models the unblocking process (increase of g) due to the treatment. Equation (8) says that the unblocking process continues after the treatment stopped, but with a slower rate than during the treatment. Substitution of (6), (7), and (8) into (1) and solving it will show how the voltage v changes in time. Clinical experiments are required to test this model. We next look more closely at the treatment process, e.g., how T2 (t) can be obtained. Clinical experiments performed by Manaka and ourselves seem to agree with the traditional five-phase theory. The following example with colors shows this [11]. To reduce pressure pain on LI-4, a metal channel point, applying red to LU10, a fire point on a metal channel, will reduce the LI-4 pressure pain. Here, fire restrains metal, red on a metal channel restrains the channel. Applying black to LU-10 will cause the LI-4 pressure pain to return. Here water restrains fire. Black on a fire point reduces the restraining effect of fire on the metal channel.

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The simplest conceptual model of the classical five-phase theory in the case of one channel can be formulated as follows. Given a stimulation of one or several of the five acupoints corresponding to different phases, on the channel under consideration, these five acupoints stimulate each other according to what the traditional theory calls engendering and restraining cycles. Then the stimulation of the channel is proportional to the resulting stimulation of the acupoint that belongs to the same phase as the channel. The simplest mathematical interpretation of this model gives a linear five-dimensional dynamical system. We illustrate our approach in the case of our example of the wood (liver) channel. Let Sj (t), j = 1 ....,5 (assume j = 1 for water, j = 2 for wood etc.) denote the amount of stimulation of j-th point on the wood channel. Suppose our treatment was to supplement the water point by signal R. Then the simplest mathematical model describing the effects of this treatment is given by the system of five linear differential equations (see also [16]).

(9)

dS1

-

dt

= aS 5 - aS4 - cS1 - ds2 -eS 3 + R(t), t

~

t1 ,

~ = aSj-1 -bSj-2- cSj- dsj+l -eSj+2, j = 2, 3, 4, 5, where R(t) = R = const > 0 for t1 ditions:

~

t

~

t2 , R(t) = 0 otherwise; with the initial con-

sj = o, j = 1, ...., 5. Here a, b, c, d, e > 0. The first equation in (9), for example, says that the rate (10)

of change of stimulation of the water acupoint is proportional to the stimulation Ss (engendering) of the metal point, to the negative stimulation S4 (restraining) of the earth acupoint, to the negative stimulation S1 (homeostatic) of the water acupoint, to the negative stimulation S2 (counter-engendering) of the wood acupoint, to the negative stimulation s3 (counter-restraining) of the fire acupoint, to the stimulation R(t) from the treatment.

Liver (wood) channel

Figure 19.8

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Appendix Five: A Mathematical Model for the Five Phases

Solving (9), (10) we obtain in particular S 2 (t) which gives us the resulting effect of the treatment on the wood acupoint on the (wood) liver channel, we next set T2(t) = S2 (t), i.e., we assume that the stimulation of the liver (wood) channel equals the stimulation of the wood acupoint.

CONCLUSIONS We have explored mathematically some concepts and clinical data from classical acupuncture. We have attempted to convince the reader that a shift in attitude is possible so that questions of the type "what does all this mean?" are replaced by questions, "How accurate is a particular model?" and "What are the appropriate experiments to verify it?" Though we are not aware of any rigorous experiments to support our analysis, still the abundance of anecdotal data convinced us that our attempt was worthwhile. We have started with a simple electric circuit model of the skin, which accounts for the measurements of some of the electrodermal instruments such as Motoyama's AMI. The initial electric current BP is interpreted as an indication of the condition (as determined by traditional acupuncture procedures) of a channel. High BP corresponds to repletion, low BP corresponds to vacuity, in traditional terms. Rigorous experiments are required to verify this correspondence. Manaka's clinical results (confirmed by our own) show that application of a small voltage to non-acupuncture points on a channel and to the mother and child points reduced pressure pain independent of whether the channel was vacuous or replete. In view of the importance of this homeostatic mechanism, we intend to conduct triple-blind experiments to verify this. To account for these results, we introduce a mathematical model similar to that of a synapse membrane with two ionic channels and assume that the applied voltage affects the conductances of the ionic channels. Further research is required to determine actual mechanisms. In figure 19.6, we develop Manaka's idea showing how treatment regulates at the signal level which alters channel conductances, which in tum creates anatomophysiological changes. We corroborate Manaka's suggestion that the five phases and their acupoints belong to the signal level as regulatory mechanisms. Next, we develop a phenomenological model of the five-phase laws in the case of a single channel and use it to describe in real time the development of a disease (which we interpret as blockage in a channel) and its treatment (which we interpret as the corresponding unblocking process). Again, we plan to conduct clinical experiments and monitor them by using AMI or other related equipment. We also intend to examine detailed parametric properties of solutions of our differential equation models, both analytically and numerically, and compare the mathematical predictions with related data. An extension of equation (1) will replace it by an appropriate partial differential equation to account for the travelling wave fronts measured by Motoyama [20]. We also plan to develop a mathematical model for the complete channel system.

REFERENCES [1] Unschuld, P., Medicine in China: A History of Ideas, Berkeley, CA: University of California Press, 1985. [2] Unschuld, P., Medicine in China: Nan Ching, The Classic of Difficult Issues, Berkeley, CA: University of California Press, 1986.

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[3] Carpenter, G. and S. Grossberg, "Dynamic Models of Neural Systems," "Oscillations in Mathematical Biology," Springer-Verlag Lectures in Biomathematics pp. 102-196, Secaucus, NJ: SpringerVerlag, 1983. [4] Tiller, W.A., "On the evolution of electrodermal diagnostic instruments," Journal of

Advancement in Medicine 1:1, Spring 1988. [5] Zhu, Zong-Xiang, "Research Advances in the Electrical Specificity of Meridians and Acupuncture Points," American Journal or Acupuncture 9 (3):203-216, 1981. [6] Li, Ding-Zhong, Jing Luo Phenomenon II, Kyoto: Yukonsha, 1985. [7] Li, Ding-Zhong, Jing Luo Phenomenon I, Kyoto: Yukonsha, 1984. [8] Tiberiu, R., G. Gheorghe and I. Popescu, "Do Meridians of Acupuncture Exist? A Radioactive Tracer Study of the Bladder Meridian," American Journal of Acupuncture 9 (3):251-256, 1981. [9] Omura, Y., "The bidigital 0-ring test and its use for imaging the internal organs and their corresponding meridians." Symposium paper. [10] Manaka, Y. and K. Itaya, "Acupuncture as intervention in the biological information system (Meridian treatment and the X-signal system)," Annual Assembly of the Japan Meridian Treatment Association address, March, 1986. [11] Manaka, Y., K. Itaya and S. Birch, Chasing the Dragon's Tail, Brookline, MA: Paradigm Publications, 1995. [12] Manaka, Y. and K. Itaya, "Thoughts about Ryodoraku total regulation therapy," Nihon

Ryodoraku Jiritsushinkei Gakkai Journal, March, 1986. [13] Melzack, R. eta!., "Trigger Points and Acupuncture Points for Pain," Pain 3:3-23, 1977. [14] Motoyama, H., "A Biophysical Elucidation of the Meridian and Ki-Energy," Inti. Assoc. Relig. & Parapsychol. (1981) 7:1, p.1-78, 1981. [15] Omura, Y., "Effects of an electrical field and its polarity on an abnormal part of the body or organ representation point associated with a diseased internal organ, and its influence on the bi-digital 0-ring test (simple, non-invasive dysfunction localization method) and drug compatibility test - part 1," Acupuncture and Electrother. Res. Int. J. 7, pp.209-246, 1982. [16] Birch, S. and M. Friedman, "On the development of a mathematical model for the 'laws' of the five phases," American Journal of Acupuncture, 17, 4, 361-6, 1989. [17] Manaka, Y., K. Itaya K. and S. Brown," Abdominal diagnosis and indications in traditional Chinese medicine," American Journal of Acupuncture 13:3, p.223-234, 1985. [18] Manaka, Y., "The skin distinguishes color and sound!? An approach to qi, the origin of Oriental medicine," Ida no Nippon magazine, May, 1987, p. 91-98. [19] Manaka, Y., "Speculation on 'qi' in Chinese medicine as media in the signal system," Japan

Shinkyu Topology Conference, Kyoto, July, 1988. [20] Motoyama, H., "Electrophysiological and preliminary biochemical studies of skin properties in relation to the acupuncture meridian," Inti. Assoc. Relig. & Parapsychol. 6, p.1-36, 1980.

FURTHER THOUGHTS ABOUT THE POSSIBLE NATURE OF THE X-SIGNALS BY STEPHEN BIRCH

It is useful to speculate on the possible nature of the signals involved in Manaka's X-signalling system. Ultimately it may be impossible to designate one or a class of possible candidates as exact signals. One is reminded of Lao Zi's famous saying: "The dao that can be spoken of is not the eternal dao." But it is useful from the point of view of potential scientific research to identify potential candidates. When we think about or study these issues we should reject seeing one or more as "correct" and the rest as "wrong" or irrelevant. For all we know, the signalling system is like a large orchestra with each member playing a different instrument in a seamless musical whole. As long as the methodologies employed are appropriate, it will be possible to explore many models. However, beginning where Manaka left off will not be easy. Manaka' s signal system model of acupuncture was discovered through the use of inquiry methods appropriate to the subjects investigated. It fits the criteria for a developed theoretical model and avoids the problems that plague both the integrationist and strictly scientific approaches to acupuncture. It avoids paradigmatic contradictions as well. As a logical description of acupuncture and as a biological model, it neither contradicts the traditional theories (where they have held up to experimental analysis) nor the principles of biology. Essentially, Manaka has proposed that these theories describe how very small signals, produced both within and without the body, are transformed at specific loci and amplified to produce physiological changes of greater extent. I Manaka's theories describe how the material of physiology- all the electronic, protonic, atomic, molecular, and cellular events that are the mainstay of physiology, are regulated by an underlying information system. The theories of yin-yang and five phases describe how aspects of this system work and can be controlled. They describe a kind of subphysiological system, perhaps one that lies in the infinitely complex realm of microenergetic events: the electrical currents, fields, magnetic fields, electromagnetic fields and waves, that are the products of physiology, but which are the matrix within which physiological phenomena occur and are regulated. Thus the language of acupuncture, the theories of yin-yang, do not describe physiological processes, rather they describe the microenergetic phenomena that regulate those processes. This is the essential nature of qi and the channels.

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These Chinese words describe the actions of a complex, interconnected, information-regulatory system. They describe the communicational, informational, and regulatory events that support physiology. 2 There exist few references in the literature to ideas such as these. The following makes a clear statement that parallels Manaka's ideas: The comprehensive understanding of the lesser-differentiated states which underlie all the psychologic, physiologic, and structural manifestations of illness - the understanding of energetic states in living systems - is the great gift that Chinese medicine gives to the West. We have no counterpart to this system in Western medicine.3

There exist discoveries - often ignored by the general scientific community which also parallel these ideas. For example, the late Albert Szent-Gyorgyi, twice Nobel Laureate, discoverer of many aspects of energetic physiology, discovered a primitive, less efficient energy production system. While mostly replaced by later, more efficient systems, it is still present in living organisms, hidden or masked by these systems.4 This protometabolism is significant because it is an example of a lower order system that retains functions in the midst of greatly superior systems. Manaka's information system, the Chinese system of qi, is similar. It is a less differentiated, lower order energy system that maintains its functions in the midst of a veritable symphony of higher-order functions. Perhaps what the Chinese have called qi is an undifferentiated energy, the matrix of all derivative forms of energy. In acupuncture and Chinese medicine, differentiated forms are labeled as a specific qi, for example, the ying qi, wei qi, gu qi, etc. In physical, chemical, or biological terms it might be characterized by, exhibit properties of, or propagate signals via many different mechanisms, routes, and forms of energy. The following is a list of possible routes or mechanisms that may participate in such a system. It comprises a compilation of concepts, models, and mechanisms from a wide variety of sources. Rigorous research needs to identify which, if any, of these participate in the signal system and under what circumstances. It is not improbable that many of these phenomena are characteristics of the signal system. The inquiry methodologies were quite different, but often the perspectives are similar. Included in this list are more general discussions of models and concepts that might describe, or lead to a description of, the underlying mechanism that unites these as a whole. Theoretically such a level exists, a very primitive, basic energy form, from which other forms are derived. It is hard to describe. The term qi is much more convenient!

MODELS OF POSSIBLE PARTICIPANTS IN THE SIGNAL SYSTEM The very nature of the subject suggests that there are many models. It is impossible to review them all or to discuss them in detail. We list good candidates. According to traditional Chinese ideas, there would be a primitive or primordial field phenomenon from which all of the following would be derivative forms. Thus, it is also useful to speculate on the nature of this general field. Researchers will need to map what occurs in the context of each phenomenon. In scientific terms, we are only at the point of discussing appropriate means and methods of inquiry. The following is thus speculation. ELECTRICAL POSSIBILITIES:

There are many renowned and respectable studies on the electrical characteristics and properties of the body, some of which have already adopted perspectives

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similar to those Dr. Manaka proposed. Many come from diverse fields, often without knowledge of the others:

- The electro-dynamic field theory of Harold Saxton Burr of Yale.s All events in the body generate fields which interact as a whole field. This field determines the activities of its parts and in turn is determined by those parts. - The semi-conductor system of interconnected molecular systems and the quantum considerations of Albert Szent-Gyorgyi.6 Oschman extends SzentGyorgyi's model to include the connective tissues and in particular the planes of fasciae, allowing communication between every cell and every other cell, every organelle, and all other organelles? - The DC current system described by Robert Becker, which is associated with growth, healing, and regeneration and which is thought to correlate to the acupuncture channels and their points.B - The various currents which have been found associated with embryological development, orientation of neurones, muscle cells, the prediction of the sites of limb bud formation, etc.9 - The battery properties of the epidermis and the current of injury in relation to piercing the skin.10 - The ionic currents of the body which compose the biologically closed electric circuits of Bjorn Nordenstrom.11 - The electrical fields associated with neural and muscular activities which communicate throughout the body, triggering responses in cells tuned to the frequencies of associated cells, the window effects of Adey (the signatures associated with the temporal features of the fields accompanying the contraction of muscle tissues).12 - The contracting muscles that generate sounds which move within the body. In the correct medium, such as water, these sounds can be communicated between organisms. Research has shown that these sounds sometimes encode information.13 - The sensitivity of the body surface to very weak electrical fields, both close and distal- projected- fields, as described by Yoshiaki Omura.l4 - Possible antenna properties of a needle inserted through the skin and its electrical effects upon the body.15 - Possible piezoelectric effects of needle insertion.16 - The correlations of frequency-dependent relationships that exist between particular organs, tissues, the body surface and electrical fields. In 1974, Arthur Pilla described models of how electrochemical information can be transferred across cell membranes, how a cell can be stimulated, inhibited, or exhibit passive response depending upon the frequencies and amplitudes of the signals employed.1 7 - The quantum studies and speculations on bioelectrical functions of Wlodzimierz Sedlak of Poland. He has theorized on the integrated functions of the bioelectrical systems, for example, that of electrostasis, and the flow of electrons to the body surface with the role of protection and shielding of the body interior.lB He has further speculated on the possible magneto-hydrodynamic effects occurring in biological structures and their importance in both the generation of electrical signals in the body and the maintenance of the bioelectrical environment inside the body.19

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- Bioelectrical homeostasis and its possible relationship to acupuncture. 20 - The electrical characteristics of the channels and their acupoints, measured by many different devices and means, and speculations on the role of this electrical system relative to body functions.21 - Hiroshi Motoyama's electrical studies of the channel systems and his speculations on the nature of qi.22 - The superconductive properties of specific tissues, cell structures, and molecules, and their possible role in living processes.23 Biological superconductivity is seen as an important mechanism for allowing organisms to maintain homeostasis. Some authors have even speculated on the roles of this relative to the acupuncture points and channels.24 MAGNETIC POSSIBILITIES

It is difficult separating magnetic properties from electrical properties because wherever we have a moving electric charge- electrons, protons, ions, etc. we also have magnetic fields. Since research has shown that electrical fields and currents are generated at all levels of physiological activity, then in all likelihood so too are magnetic fields. Specific measurements of these magnetic fields have been made using sensitive equipment. The magnetic fields represent another set of information carriers concomitant with the electrical carriers. The following is a list of some of the measured fields and their proposed properties:25 - John Zimmerman has done considerable research into the magnetic fields of the body, in particular the brain and its responses to varied perceptive stimuli, the magnetic fields associated with palm healing or therapeutic touch. He has also speculated on the general functions of these fields, particularly in healing.26

- The earth's magnetic field has been shown to be very important to life, to the timing and integration of normal physiology, and to be related to various disorders including psychiatric disturbances and possibly even cancerP Some authors have speculated on the roles of biomagnetic homeostasis relative to the actions of the geomagnetic field.28 - William Tiller has proposed that part of the nature and origin of the electrical potential in the channels, in particular the battery-like effect of the acupoints, is generated by the magnetic vector potential field. Such a proposal accounts for phenomena observed in the acupoints.29 - In his studies of the bi-digital 0-ring test, Omura has speculated on the possibility that electromagnetic resonance phenomena participate in the use of the test for localizing and identifying molecules in the body. In general, the phenomenon of electromagnetic resonance can be said to also carry information between like substances that resonate.30 - Molecular mechanisms may be involved in a variety of magnetic field phenomena.31 ELECTROMAGNETIC POSSIBILITIES

Just as cinematic images appear to be real but are only combinations of light and shade, so is the universal variety as delusive seeming. The planetary spheres, with their countless forms of life, are naught but figures in a cosmic motion picture. Temporarily true to man's five sense perceptions, the transitory scenes are cast on the screen of human consciousness by the infinite creative beam. 32

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As well as the electrical and magnetic fields, currents that can act as carriers of signals or information, there are more diverse electromagnetic fields and waves: light in all of its various forms, both visible and non-visible, coherent and noncoherent. Sedlak has measured this extensively in his research and has proposed models of how the living organism creates and utilizes such energies: The evolutionary mechanisms sought in the relation to environment can be solved by reducing both sides to a common nature. The author conceives the organism and environment in terms of electromagnetic fields. At every level of complexity the organism emits electromagnetic radiations. This applies to individual cells (mitogenetic radiation) as well as to organs and to the whole complex organism. Human brain radiations have been best studied so far. The '"metabolism'" of electromagnetic energy is a manifestation of life as much as the transformation of matter. The biological field with its electromagnetic qualities is a universal manifestation of life. The organism may be considered as an oscillator emitting biological field with large band spectrum. 33

All molecular changes, interactions, etc., produce electromagnetic radiations that travel away from their origin. Different tissues, different molecules, and atoms, are tuned to radiations of specific wavelengths and frequencies. Frequently biological organisms even project coherent light in the form of laser-like light.34 Throughout evolution all levels of organization seem to have taken advantage of this production of energy and sensitivity to specific energies. Several authors have developed theories of how these energies are utilized. For example, Philip Callahan, in his studies of insect communication systems, found that such sensitivities exist and are very much exploited.35 He has further postulated that molecules and atoms emit "inversional and rotational emission waves" that are particular to an atom or molecule, have "signatures," that hold information about the state of the molecules and atoms, and can be read by molecules and atoms elsewhere which are tuned to those waves. This system of molecular emissions exists throughout nature in all living things and in the environment. There exist an almost infinite number of signal carriers, of information in the environment and within and between all living things. Concepts such as these have been discussed by a variety of authors. In a related theory, Herbert Weaver, a telegraph company worker from England, devoted his retirement to the study of the phenomenon of divining. He researched the mechanisms of this ancient art, proposing that it uses the radiations naturally emitted by all objects. He provided evidence showing that natural systems are tuned to these radiations as a kind of "primary sense," a very ancient method of sensing things in the environment. He further argued that living things developed geometrical forms and shapes that served to disguise their radiations so that their predators could not find them. He also proposed that primitive man's writings and drawings used forms and figures which could elicit similar responses.36 Weaver's theories resonate with Manaka's discussions about the possible origins of acupuncture, as a kind of primitive sense that has been lost to more modem civilized man. Similar discussions have also been initiated by physicist and acupuncturist Yasumasa Katsumata, a colleague of Dr. Manaka. In particular, Katsumata arrived at the concept of sayoshi, a phantom function or effect that can be transferred between objects, that is not itself material, and that can even be left in the place or space which an object formerly occupied. He first began studying the mechanisms of the bi-digital 0-ring test and through extensive research arrived at this more general theory. He proposed that it is the emission of "molecular waves," in the ultra-infrared or microwave range, which produces the effect. This

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is similar to the concepts described by Callahan and Weaver.3 7 His general theory is discussed in appendix 4 of this text. His findings and speculations are not dissimilar to research findings in the study of qigong, where many research groups have identified low frequency infrared radiation as a factor.3 8 The findings of lkuro Suehara, a Japanese physicist and acupuncturist, may also be relevant here. Through his research using pure samples of individual chemical elements and muscle testing, he has found correlations between the effects of pure elements from within a vertical column of the periodic table of elements and a single channel. He has reportedly mapped these correlations for all the channels. These possible correlations need more rigorous investigations, but if correct, they reveal some significant bioenergetic correlates to the theories of acupuncture which could potentially be "signal" mechanisms in Manaka's more general theory.39 It is clear from these discussions that there may be many mechanisms involved in acupuncture, at many levels of electrical, magnetic, and electromagnetic activities, all of which may act as carriers of the signals described by Dr. Manaka. It is helpful to look further at proposals of a more global nature that try to explain the whole field in simpler terms. If only a few of the above mechanisms participate in the signal system, it is indeed a very complex and powerful system. To grasp it, a simpler, more encompassing theory would be helpful. William Tiller has proposed a sophisticated and far-reaching model that is not only able to explain the effects of acupuncture, but many other healing disciplines, ancient practices, etc. This model has come from his many years researching acupuncture, meditation, and paranormal phenomena. Though his work is as yet unpublished, his many papers outline the basic theory.40 He has proposed the existence of "positive space-time," the realm most easily accessible to our senses, and "negative spacetime," a more subtle world that coexists with the positive: Whereas positive space/time matter is associated with the forces of electricity and electromagnetic (EM) radiation, negative space/time matter is associated primarily with magnetism and a force which Tiller describes as magnetoelectric (ME) radiation. 41 In negative space/time, energy is magnetoelectric and negatively entropic and substance is of a subtle magnetic character.42

It is possible that this theory, worked out in some detail by Tiller and already correlated to acupuncture and the energy fields of the body, especially the "subtle bodies," may be able to explain many of the phenomena observed by Dr. Manaka and describe the general nature of the signals. The holographic paradigm is another possible global model of how signals may be produced, propagated, and received. David Bohm's theory of implicate order and holographic nature is pertinent.43 In such a universe, higher levels of order and information may be holographically enfolded in the fabric of space and matter/energy. Because what happens in just a small fragment of the holographic energy interference pattern affects the entire structure simultaneously, there is a tremendous connectivity between all parts of the holographic universe.44

Aside from the obvious correlations of this model to the model described above (i.e., the connectivity of all parts to each other), the storage and transfer of information between all parts of the system, it can also be seen as a good candidate for describing some of the signals that participate in Manaka's signal system. There have been other speculations on the role of the holographic paradigm in acupuncture.45

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Rupert Sheldrake's theory of the morphogenetic field may also be relevant. Sheldrake, a biologist, postulated a theory that has weathered scientific scrutiny. He proposed that non-physical, morphogenetic fields exist. They guide morphological development, activity of forms, etc. This represents another candidate for describing the global regulation of information storage, transfer, and activity.46 In a more limited biological model, we can postulate that the global regulation mechanisms, which function to allocate energy within species and individual organisms, may also be relevant. This is sometimes called "the principle of allocation."47 On a larger scale, but still in a limited biological sense, the Gaia hypothesis of James Lovelock may also be relevant. This states that the earth itself functions to globally regulate life and energy distribution.48 It is possible that regulatory mechanisms operate at many levels of organization in nature. These last two models describe how underlying principles in nature can regulate higher-order activities and functions such as the general distribution of energy and information. Order is an important function of living things; any system which can create order may be useful to life. We saw in Tiller's model that the more subtle energies of the negative space-time are negatively entropic; they create order. This seems similar to the models described above, specifically that chaotic systems seem to spontaneously give rise to order. Recent studies have unravelled exquisite mathematical principles operating throughout nature, at all levels, which give rise to order. Deep within chaotic systems are layers of hidden order.49 These are properties of whole systems and not parts of systems, and are important here because they too describe how information can be stored, transferred, and regulated. They provide further potential global descriptions of Manaka's signal system. Physiological integration is essential to life. Without ordered, well-timed, and integrated systems at all levels of activity within an organism, life would slowly begin to degenerate. This is probably the simplest way of describing how disease develops. The mechanisms of physiological integration are complex and varied, but somehow remain an integrated whole for maximal activity.SO It is probable that the systems which serve to regulate the organism are not describable solely by the normal physiological languages of molecular, atomic, and cellular interactions. There are many principles operating, many at very low energy content. If Dr. Manaka's hypothesis is correct regarding the role of acupuncture relative to this signal system, then this is indeed significant.Sl In a way, much of what Dr. Manaka has said can be seen in a simple analogy. When one walks into a factory that has been idle for the weekend, it may take only the flick of a few switches to engage the factory's equipment and machines in production again. Here, only a tiny amount of energy, - the flick of a few switches - activates many processes creating and expending huge amounts of energy. In the body, only a tiny stimulus at the skin surface can activate a multitude of processes in the body, creating and expending large amounts of energy. When the factory is already in full operation, it is regulated and controlled by similar small amounts of energy applied to appropriate leverage points: switches, buttons, dials, etc. To regulate the body's activities (within at least a physiological range), only small amounts of energy need be applied at key leverage points. In the factory, the languages describing the energies of general activity will be electrical, magnetic, thermal, etc. In the body, the Chinese described energy as qi in a variety of forms, and, using yin-yang, five phase, and channel theories, they described how one is able to choose the appropriate leverage points to create change. In modem biological language, the inner workings of the body are complex and enmeshed. Possibly all of the mechanisms discussed here participate in the regulation of physiological activity. The Chinese descriptions of these concepts are difficult at best.

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Modem physiological descriptions are also complex, and may best be simplified, at least while the full model is being researched, in appropriate general languages. In addition to describing this unbelievably complex interpenetrating regulatory system in the technical languages of systems and information theory, we may also use the language of mathematics. In particular, the language of topology, three dimensional geometry, and the use of more recent mathematical ideas developed in the studies of chaos, may be useful. Finding an appropriate language for describing certain characteristics that arise from global interactions and not local properties can be difficult. Dr. Manaka frequently referred to the language of three-dimensional geometry, or topology, as a valid manner of describing some of the theories of acupuncture. He founded and was president of the Shinkyu Topology Group (the Acupuncture and Moxibustion Topology Group), holding yearly meetings in Kyoto. This group has shown how the language of topology can be useful in describing complex phenomena in acupuncture. The term "connectedness" is important for modern views of nature; if all things are inseparable and non-reducible, then they are all connected. "At all levels, from atoms to persons, connection is a requirement for life."52 Cunningham proposes that: Health depends on a property which may be called "connectedness," an optimal passage of information between the levels of the organism and its environment. The right kind and amount of information must be transmitted to maintain health. 53

Disease is the reverse, what he calls "disconnectedness." If these views are correct, and commonsense interpretation of the information and systems theory models of life suggest that they may be, then connectedness is an important property of living things. We find the property of connectedness in the study of topology. Connectedness is a topological property; thus the use of the language of topology for describing connectedness in the living body may be useful. Dr. Manaka takes advantage of this with his sophisticated theories regarding structure-function relationships, especially those inherent in octahedral theory. Mathematics can also be used to describe yin-yang and the five phases phenomenologically. The behavior of the body's yin-yang and five-phase systems seem to have such precision that it is not unreasonable to suggest that the language and descriptions of these theories may be referring to mathematical rather than merely philosophical concepts. In appendix 5, two papers are presented that develop such phenomenological models, providing a minimal mathematical description of the five phases and their various interactions. Important parallels to Manaka's information model derive from these descriptions. In particular, we found that for the system of five interacting phases to remain in balance, which is the essential nature of the system according to traditional descriptions, what passes between each phase must have a qualitative and not a quantitative nature. That is, the five-phase interactions must be informational in nature. For example, if we think of what is passing between the water and wood phases in the sheng cycle, as quantities of stuff (i.e., xue, gu qi, ying qi, zong qi, etc.), then the system of five phases cannot maintain balance. Only when we reduce the amount to near zero, i.e., to a qualitative entity such as information, can the system work as described. Working in consultation with William Tiller, we developed a mathematical model that bridges the gap between traditional descriptions of a channel and the simplest electrical model of a channel- based on electrical measurements -the five

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phases, the actions of the five-phase points, observed clinical findings, and clinical applications. In short, we have the beginnings of a mathematical model that is able to describe research findings, traditional descriptions, and clinical practice. This particular model is important because it interfaces traditional concepts with scientific measurements and tests using a "neutral language." If we are to develop a full scientific model of acupuncture, we must first develop a precise idea of what is testable with rigorous scientific methodology. Only thus may the theory be raised to the standard of science. It is our intention to rigorously investigate the specific findings of Dr. Manaka which have led to the formation of the signal system model. Mathematical models are the starting point for this research. It will take much careful work to unravel the traditional theories and mechanisms of acupuncture and Manaka's X-signal system. We hope this work will contribute to that process.

NOTES 1 The idea that tiny stimuli or signals produce therapeutic effects is similar to one expressed by Speransky: "Hence we obtain the rule that only weak degrees of irritation can have a useful significance, strong ones inevitably do damage." A Basis for the Theory of Medicine, quoted from Chaitow, L., Soft-Tissue Manipulation, p. 66. 2 In Hara Diagnosis: Reflections on the Sea, we develop an argument that shows the parallels between traditional Chinese descriptions and modem scientific discoveries, specifically the observed field and energetic phenomena. See chapters eight and nine. 3 Kobrin, L.E., "The role of Chinese medicine in modem medicine," Jefferson Alumni Bulletin, pp. 12-18, Winter 1988. 4 Szent-Gyorgyi, A., "Protometabolism," Int. Jour. Quant. Chern., "Quant. Bio. Symp. 11," pp. 6367,1984. 5 Burr, H.S. and F.S.C. Northrop, "An electro-dynamic theory of life," Quart. Rev. Bioi. 10:3, pp.322-333, 1935; and Burr, H.S., The Fields of Life, New York: Ballantine Books, 1972. 6 Szent-Gyorgyi published many books and papers on this subject. The following is a good example of his work: Szent-Gyorgyi, A., Introduction to a Submolecular Biology, New York: Academic Press, 1960. 7 Oschman, J.L., "The connective tissues and myofascial systems," paper presented at the Rolfing '81 conference in Los Angeles; Oschman, J.L., "The structure and properties of ground substance," Amer. Zoo!. 24:1, pp. 199-215, 1984. See also Matsumoto, K. and S. Birch, Hara Diagnosis: Reflections on the Sea, chapters seven, eight and nine, where this concept is explored and correlated to traditional Chinese and Japanese medical texts and theories. See also the more recent text, Oschman, J.L., "A biophysical basis for acupuncture," The Proceedings of the First Symposium of the Society For Acupuncture Research, Boston, MA, Society for Acupuncture Research, 1994. 8 Becker, R.O. and A.A. Marino, Electromagnetism and Life, Albany: State University of New York Press, 1982; Becker, R.O. and G. Selden, The Body Electric, New York: William Morrow, 1985; Becker, R.O., "Electromagnetic controls over biological growth processes, Jour. Bioelect. 3:162, pp. 105-118, 1984. 9 For discussion see: Jaffe, L.F., "Developmental currents, voltages and gradients," in Subtelny, S. and P.B. Green, Developmental Order: Its Origin and Regulation, New York: A.R. Liss Inc., 1982, pp. 183-215. 10 Barker, A.T. et al., "The glabrous epidermis of cavies contains a powerful battery," Amer. Jour. Physiol. R358-366, 1982. The "current of injury" is discussed in many places. See for example, Becker, R.O., "The basic biological data transmission and control system influenced by electrical forces," Ann. N. Y. Acad. Sci. 238, p. 236, 1974; Becker, R.O. and A.A. Marino, Electromagnetism and Life, pp. 14-16. Both of these are discussed in Stux, G. and B. Pomerantz, Acupuncture Textbook and Atlas, Berlin: Springer-Verlag, 1987, pp. 23-24. 11 Nordenstrom, B., Biologically Closed Electric Circuits, Sweden: Nordic Medical Publications, 1983. 12 Adey, W.R., "Tissue interactions with nonionizing electromagnetic fields," Physiol. Rev. 61:2, pp. 435-514, 1981; Sawin, S.W. eta!., "Ionic factors in release of 45 Ca2+ from chicken cerebral tissue by electromagnetic fields," Proc. Nat!. Acad. Sci. USA 75:12, pp. 6314-6318, 1978; Williamson, S.J. and L. Kaufman, "Biomagnetism," Jour. Mag. and Mag. Mater. 22, pp. 129-201, 1981.

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Appendix Six: Thoughts About the Nature of the X-Signals

13 Oster, G., "Muscle sounds," Scientific American, p. 108-114, March 1984. 14 Omura, Y., "Effects of an electrical field and its polarity on an abnormal part of the body or organ representation point associated with a diseased internal organ, and its influence on the bi-digital 0-ring test (simple, non-invasive dysfunction localization method) & drug compatibility test - Part 1," Acup. & Electrother. Res. Int. J. 7, pp. 209-246, 1982. 15 Romodanov, A.P. et al., "Antenna properties of acupuncture needles," Vrachebnoe Delo 8, pp. 93-96, 1984; abstract in Amer. Jour. Acup. 13:1, p. 74, 1985. 16 Oschman, J., op.cit., discusses the piezoelectric properties of the connective tissues, and thus skin. See "The connective tissue and myofascial systems." paper presented at the Rolfing '81 conference in Los Angeles. See also, Lipinski, B., "Biological significance of piezoelectricity in relation to acupuncture," Medical Hypotheses 3:1, pp. 9-12, 1977. 17 Presman, A.S., Electromagnetic Fields and Life, New York: Plenum Press, 1970. See pp. 52 and following for examples of tissue frequencies. Pilla, A.A., "Electrochemical information transfer at living cell membranes, Ann. N. Y. Acad. Sci. 238, p. 149, 1974. William Tiller describes the possibility that the channels and their acupoints represent the surface flows of energy associated with the functioning state of the internal organs. The characteristics of these energy flows relate to specific pathways, etc. See Tiller, W.A., "On the evolution of electrodermal diagnostic instruments," Jour. Advancement in Med. 1:1, pp. 41-72, 1988. He further describes different effects that result from at least two frequencies of stimulation at the skin. See Tiller, W.A., "What do electrodermal diagnostic acupuncture instruments really measure," Amer. Jour. Acup. 15:1, pp. 15-23, 1987. 18 Sedlak, W., Bioelektronika, 1967-1977, Poland: Instytut Wyadawniczy, 1979. On pages 82-85 is a good summary in English of his concept of electrostasis, its origins, nature and functions. 19 Ibid., pp. 203-205. 20 Zukauskas, G. et a!., "Quantitative analysis of bioelectrical potentials for the diagnosis of internal organ pathology and theoretical speculations concerning electrical circulation in the organism," Acup. & Electro-ther. Res. Int. J. 13, pp. 119-130, 1988. See also Nordenstrom, B., Biologically Closed Electric Circuits, and Sedlak, W., Bioelektronika 1967-1977. 21 For good reviews of the literature and the specifics of what the measurements really measure, see: Zhu Zong-Xiang, "Research advances in the electrical specificity of channels and acupuncture points," Amer. Jour. Acup. 9:3, pp. 203-216, 1981; Tiller, W.A., "On the evolution of electrodermal diagnostic instruments," Jour. Advancement in Med. 1:1, pp. 41-72, 1988; Tiller, W.A., "On the evolution and future development of electrodermal diagnostic instruments," in Energy Fields in Medicine, Kalamazoo, Michigan, John E. Fetzer Foundation, 1989, pp. 257-328. 22 See for example, Motoyama, H., "Electrophysiological and preliminary biochemical studies of skin properties in relation to the acupuncture meridian," Research Relig. & Parapsych. 9, 1980. Also, Motoyama, H., "A biophysical elucidation of the meridian and ki energy. What is ki energy and how does it flow?" Research Relig. & Parapsych. 7, p 1, 1981. 23 See for example, Cope, F.W., "Evidence from activation energies for superconductive tunneling at physiological temperatures," Physiol. Chern. Phys. 5:3, pp. 173-176, 1971; Cope, F.W., "Biological sensitivity to weak magnetic fields due to biological superconductive junctions," Physiol. Chern. Phys. 5, pp. 173-176, 1973. 24 See for example, Dubrov, A.P., The Geomagnetic Field and Life: Geomagnetobiology, pp. 152-153. 25 For a good review of the general literature in this area, see Williamson, S.J. and L. Kaufman "Biomagnetism," op.cit. 26 See for example, Reite, M and J.T. Zimmerman, "Magnetic phenomena of the central nervous system," Ann. Rev. Biophys. Bioeng. 7, pp. 167-188, 1978; Zimmerman, J.T. et al., "Auditory evoked magnetic fields: A replication with comments on the PSO analog," II Nuovo Climento 2D:2, pp. 460-470, 1983; True, B., "Professor tunes in on touch healers," Up the Creek 4:56, February 14-20, 1986; Zimmerman J.T.; Laying-on-of-hands and therapeutic touch: a testable theory," Newsletter of the Bio-Electro-Magnetics Institute 2, 1, 8-17, 1990. 27 There is considerable literature in this area. The most comprehensive is perhaps A.P. Dubrov's work, The Geomagnetic Field and Life: Geomagnetobiology. This text is a landmark in the field. Many other authors have researched and speculated on the significance of the geomagnetic field. Robert Becker has speculated on the role of the channels relative to the varying geomagnetic field. See Becker, R.O., "Electromagnetic controls over growth processes," op.cit. Kyoichi Nakagawa, a Japanese physician, has uncovered a variety of disorders which result from underexposure to the geomagnetic field; see Nakagawa, K., "Magnetic field deficiency syndrome and magnetic treatment," Japan Medical Jour. 2745, 1976. Other literature of interest relates to studies of specific disease entities. See Friedman,

Appendix Six: Thoughts About the Nature of the X-Signals

423

H. et al., "Psychiatric ward behavior and geophysical parameters," Nature 205, pp. 1050-1052, 1965; Marton, J.P., "Conjectures on superconductivity and cancer," Physiol. Chern. Phys. 5, pp. 259-270, 1973. Elsewhere, we discussed some of the roles of the geomagnetic field and explored possible correlations to Chinese biorhythm ideas; see Hara Diagnosis: Reflections on the Sea, pp. 74-75,216-221. 28 Dubrov, A.P., op.cit., p.152. 29 On the evolution of electrodermal diagnostic instruments; op.cit. 30 For further discussions, see: Omura, Y., "Electromagnetic resonance phenomenon as a possible mechanism related to the 'hi-digital 0-ring test molecular identification and localization method'," Acup. & Electrother. Res. Int. J. 11, pp. 127-145, 1986. 31 For a good summary of the possible see Surgalla, L.A., "Molecular mechanisms of magnetic medicine," Magnets; 3:4, p. 14, April1988. 32 Paramahansa Yogananda, Autobiography of a Yogi, pp. 318-319. 33 Sedlak, W., Bioelektronika 1967-1977, pp. 82-83. 34 Ibid. 35 Callahan, P.S., Tuning into Nature: Solar Energy, Infrared Radiation and the Insect Communication System, Old Greenwich, CT: Devin-Adair, 1975. 36 Weaver, H., Divining the Primary Sense: Unfamiliar Radiation in Nature, Art and Science, London: Routledge and Kegan Paul, 1978. 37 See: Katsumata, Y., "Fundamental studies of the 0-ring test," Ida no Nippon Sha, 504, August 1986; 505, September 1986. See also Katsumata, Y. with comments by Y. Manaka, "On certain unknown factors, hypothetically named 'sayoshi' by Y. Katsumata, which affect the living body," Unpublished manuscript, December 1988. 38 Qian Cun-Ze et al., "Simulated human-body information in bio-medical therapy," unpublished manuscript; Shen, G.J., "Study of mind-body effects and qigong in China;" Advances; 3, 4, 134142, 1986; Sampson, R., "A survey of qi related research- East and West," paper presented in conjunction with the Sino-U.S. Qigong health sciences exchange program, first U.S. symposia series, September 14-26, 1985, Beijing. 39 See for example, Suehara, I., Genso Keiraku Ho (Fundamental Channel Therapy), p. 11, Onso Shindangaku Kenkyujo Research Institute, 1985. 40 See for example Tiller's Introduction to Motoyama, H., Science and the Evolution of Consciousness: Chakras, Ki and Psi, Cambridge, MA: Autumn Press, 1978, pp. 9-19. One of the better summaries and descriptions of his ideas can be found in Gerber, R., Vibrational Medicine, Santa Fe: Bear and Company, 1988, pp. 143-153 and 503-507. 41 Gerber, R., Vibrational Medicine, op.cit., p. 147. 42 Ibid., p. 506. 43 See Bohm, D., Wholeness and the Implicate Order; Wilber, K., The Holographic Paradigm and Other Paradoxes. 44 Gerber, R., Vibrational Medicine, op.cit., p. 61. 45 See for example, Hameroff, S.R., "Ch'i a neural hologram? Microtubules, bioholography and acupuncture," Amer. Jour. Chin. Med. 2:2, pp. 163-170, 1974. 46 Sheldrake, R., A New Science of Life: the Hypothesis of Causative Formation, Los Angeles: J.P. Tarcher, 1981. 47 This is an attempt to describe global energy regulation. See for example, Campbell, N.A., Biology, Menlo Park, CA.: Benjamin Cummings Publishing, 1987, p. 1004. 48 Lovelock, J., Gaia: A New Look at Life on Earth, Oxford: Oxford University Press, 1979. 49 See for example, James Gleick, Chaos, Making a New Science; Ira Prigogine and I. Stengers, Order Out of Chaos; and Benoit Mandelbrot, The Fractal Geometry of Nature. 50 A good description of physiological integration and the views afforded by such a model are given in Adolph, E.F., "Physiological integrations in action, Physiologist 25 (supplement), p. 2, April 1982. 51 Dr. Manaka has speculated in several recent papers about the possible nature and roles of qi in this signal system. See for example, Manaka, Y., "Speculations on the media of qigong," paper presented at the National Congress of Qigong in China, fall of 1988. See also Manaka, Y., "Speculation on qi in Chinese medicine as the media in the signal system," Text of the 18th annual convention of the Shinkyu topology group, Nippon Shinkyu Topology Gakkujutsu Taikai, July 1988, pp. 6-21. 52 Larry Dossey, Space, Time and Medicine, p. 76. 53 A.J. Cunningham, "Information and health in the many levels of man."

APPENDIX SEVEN BIOGRAPHY OF YOSHIO MANAKA M.D., PHD. BORN: April23, 1911, in Odawara, Japan. DIED: November 20, 1989, in Odawara, Japan. FAMILY ADDRESS: Odawara-shi, Minami-cho, 3-4-31. EDUCATION: Graduated Kyoto Imperial University Medical School, 1935. PhD in physiology from the Kyoto Imperial University Medical School, 1957. WoRK EXPERIENCE: 1935-37, surgical department of Tokyo Imperial University. 1939-45, military service as army surgeon. 1945-1989, director of Manaka Hospital, Odawara. 1950-1989, active member of Japanese Association of Oriental Medicine. 1952-56, elected to Municipal Commitee of education in Odawara. 1957-58, elected President of Odawara Medical Association. 1974-1989, Director emeritus of Oriental Medical Research Center affiliated with the Kitasato Institute, Tokyo. 1973-83, President of M.D. Society of Oriental Medicine. 1981, Chairman of 1981 Congress of Japanese association of Oriental Medicine. 1971-83, Director of Financial Foundation for Oriental Medicine. 1978-1989, President of the Topology Acupuncture Group in Kyoto. 1968-1989, Lecturer of the Annual Summer Seminar on Acupuncture. 1975-85, Editorial staff of the Medical Encyclopedia of Kodansha in Tokyo. 1980-81, Editorial staff of the Annual reports of basic and clinical researches on acupuncture in Japan. 1960-70, President of the Toyo Shinkyu Senmon Gakko (East Asian Acupuncture and Moxibustion School) in Tokyo. Dr. Manaka taught at many international congresses and seminars in countries, including: Canada, the United States, Mexico, Uruguay, Brazil, Argentina, Spain, China, Korea, France, Germany, Holland, Egypt, Phillipines, Hong Kong, etc. Later visits to China included, for example, October, 1987: Tianjin, International Symposium on the therapeutic principle of Huo xue Hua yu, where he presented a paper entitled " Acupuncture applied for Huo xue Hua yu," November, 1986: Beijing, International Symposium on the Regulating Function of Acupuncture, where he presented a paper entitled " Acupuncture's effects on the microcirculation, especially its activation of vasomotion."

426

Biography of Yoshio Manaka

MOST RECENT AREAS OF STUDY:

1. -Speculation on "qi" in Chinese Medicine, as the media of the signal system. 2. - "Biasology" applied in acupuncture. 3. - Abdominal diagnosis in Chinese Medicine. 4. - Acupuncture as intervention in the biological information system. 5. - Placebo effects and bias effects. 6. - The Yi Jing in the field of acupuncture. PUBLICATIONS IN jAPANESE:

Kappa Zuihitsu (Kappa Essays), Ido no Nippon Sha, 1955. Byoki no Jikoshindan no Tebiki (A guide to disease self-diagnosis), Kubo Sha, 1960. Kyu to Hari (Moxibustion and Acupuncture), Shufu no Torno Sha, 1961. PW Doktor Okinawa Horyoki (POW Doctor- An Okinawan prisoner's account), Kongo Sha, 1962. Hari Kyu Kanpo (Acupuncture, Moxibustion & Herbal Medicine), Ido no Nippon Sha, 1962. Muntera- lsha to Kanja (Muntera- Doctors and Patients), Sogen Sha, 1963. Kappa Zuihitsu (Kappa Essays [letters from the spiritual world]), Ido no Nippon Sha, 1970. Shinkyu Rinsho Iten (Dictionary of Clinical Acupuncture and Moxibustion), Ido no Nippon Sha, 1970. Katakori to Yotsu (Shoulder pain and stiffness and lumbar pain), Sogen Sha, 1971. Shinkyu no Riron to Kangaekata (Thoughts and Theories of Acupuncture and Moxibustion), Sogen Sha, 1973. Okyu no Kenkyu (Studies in Moxibustion), Goma Sha, 1976. Translated into Chinese as Jiu Xue Zhi Liao Fa, Si Li Publishing Company, Taiwan. lka no Tameno Shinjutsu Nyumon Kuowa (Introductory Lectures on Acupuncture for Medical Doctors), Ido no Nippon Sha, 1980. Co-authored with Dr. Herbert Schmidt. Translated into Chinese and Korean. Hiratashi Junnihanotai Nesshin Shigeki Ryoho (Hirata-style Hot Needle Therapy), Ido no Nippon Sha, 1982. Chiguan Zuihitsu; Soroban no Mudadama (Essays to Chiguan; Playing with the Beads of the Abacus), Ido no Nippon Sha, 1988. Manaka Yoshio Ronbunshu (Collected Essays of Yoshio Manaka), Shinkyu Topology Gakkai, 15th anniversary issue, 1988. Karada no Naka no Genshi Shingo (Primordial signals inside the body: Chinese medicine and the X-signal system), co-authored with K. Itaya, Tokyo, Chiyu Publishing Co, 1990. PUBLISHED TRANSLATIONS:

Chiropractic, by W. Pepper, Ido no Nippon Sha, 1952. Tsuina Ryoho, Chugoku Anma Ryoho (Tuina Therapy, Chinese massage therapy), Ido no Nippon Sha, 1961. Naikateki Shikkan no Shinkei Ryotai Ryoho, a translation of Die neurotopische diagnose und Therapie innerer Krankheiten (Neural Dermatome Therapy for the Treatment of Internal Diseases), by Dittmar F. and E. Dohner, ldo no Nippon Sha, 1965. Kiketsu Zufu (An Illustrated Guide to the Extra Points), Ido no Nippon Sha, 1971, from the Chinese Qi Xue Tu.

Biography of Yoshio Manaka

427

FOREIGN LANGUAGE PUBLICATIONS:

L'Acupuncture, "a val d'oiseau" (Acupuncture, "as the crow flies"), Co-authored with Marc Siegel, Yokohama, General Printing Company, 1960. The Layman's Guide to Acupuncture, Co-authored with Ian A. Urquhart, Rutland, VT: John Weatherhill, 1972. Quick and Easy Chinese Massage, Co-authored with Ian A. Urquhart, Japan Publications Trading Company, 1973. Translated to Dutch, Snelle Destrijding Van Pijn, 1984. Translated to Finnish, Kiinalainen Hieronta, 1984. PAPERS:

Too numerous to mention. Hundreds of "Essays to Chiguan" in the Ida no Nippon magazine. Publication of many articles and research papers in many languages in many countries, especially journals specializing in acupuncture, herbal medicine, and Western medicine. Most recently authored the landmark paper, co-authored with Kazuko Itaya, "Acupuncture as Intervention in the Biological Information System (Meridian Treatment and the X-Signal System)," presented at the annual assembly of the Japan Meridian Treatment Association in Tokyo on March 1986, subsequently translated and published in Chinese, German, French, English, Swedish, and Spanish. Yoshio Manaka was also an accomplished poet, artist, and sculptor; there have been several exhibitions of his work over the years.

BIOGRAPHY OF KAZUKO ITAYA EDUCATION:

1968- Graduated the Toyo Shinkyu Senmon Gakko, Tokyo. 1978 - Educational certificate in a special course designated by the Minister of Public Welfare, Japan. 1980- California acupuncture and herbal medical licensure. WORK EXPERIENCE:

1974-1989 - Research fellow at the Oriental Medical research center of the Kitasato Institute, Tokyo. Her work here has been in numerous areas of research and the preparation of many papers, presented at conferences around Japan, in China and other countries. 1987-present- Councillor of the Nippon Toyo Igakukai. PUBLICATIONS:

Author and co-author of numerous papers on acupuncture published in Japan.

~~ ~ BIBLIOGRAPHY BOOKS IN ORIENTAL LANGUAGES:

Akabane, K., Hinaishin Ho [Method ofHinaishin], Yokosuka: Ido no Nippon Sha, 1964. Fujita, R., Meridian-phenomena, myogen circulatory membrane system, Yokosuka: Ido no Nippon Sha, 1964.

Ida no Nippon Journal of Japanese Acupuncture and Moxibustion, 45:4 (SOOth special issue), April1986. Ikegarni, S. (trans.), Tianjin Chinese Medical College, Shinkyu Rinsho no Riron to Jisai [Theory and Practice of Acupuncture and Moxibustion], vol. 2, Tokyo: Kokusho Publishing Association, 1988. Imaizumi, H., Ekikyo no Nazo [Mysteries of the Yi Jing], Tokyo: Kobun Sha, 1988. Irie, S., Fukaya Kyu Ho [Fukaya's Moxibustion Therapy], Tokyo: Shizensha, 1980. Kobayashi, Y., Chugoku no Atarashi Chiryooten [New Chinese Treatment Points], Osaka: Osaka Kobayashi Ryodoraku Institute, 1972. Kono, T. Kin Shin Dan Ho [Muscle Diagnosis Method], Tokyo: JICC Publishing Company, 1986. Li Ding Zhong, The Jing Luo Phenomena vols. I & II, Kyoto: Yukonsha, 1984,1985. Li Shi Zhen, Qi Jing Ba Mai Kao [An Examination of the Extraordinary Vessels], from the Tu Zhu Nan Jing Mai Jue [Discriminating Pulses from the Classic of Difficult Issues with Illustrations], Taipei: Shui Cheng Shu Ju Publishing Company, 1970. Manaka Y., Kyu to Hari [Moxibustion and Acupuncture], Tokyo: Shufu no Torno Sha, 1961. _ _, Shinkyu Rinsho Iten [Dictionary of Clinical Acupuncture and Moxibustion], Yokosuka: Ido no Nippon Sha, 1970. _ __, Katakori to Yotsu [Shoulder Pain and Stiffness and Lumbar Pain], Osaka: Sagen Sha, 1971. _ _, Shinkyu no Riron to Kangaekata [Thoughts and Theories of Acupuncture and Moxibustion), Osaka: Sagen Sha, 1973. _ __, Okyu no Kenkyu [Moxibustion Studies], Tokyo: Goma Sha, 1976. _ __, Hiratashi Junnihanotai Nesshin Shigeki Ryoho [Hirata-style Hot Needle Therapy], Yokosuka: Ido no Nippon Sha, 1982. _____ , Manaka Yoshio Ronbunshu [Collected Essays of Yoshio Manaka], Kyoto: Shinkyu Topology Gakkai, 1988. _ _, Kiketsu Zufu [An Illustrated Guide to the Extra Points], Yokosuka: Ido no Nippon Sha, 1971, translated from the Chinese Qi Xue Tu.

430

Bibliography

Manaka, Y., and Herbert Schmidt, Ika no Tameno Shinjutsu Nyumon Kuowa [Introductory Lectures on Acupuncture for Medical Doctors], Yokosuka: Ido no Nippon Sha, 1980. Miyawaki, K., Yin Yo Rokugyo Setsu no Shinjutsu [Yin Yang Six Phase Acupuncture Treatments], Tokyo: Soikai Sha, 1976. Nagahama, Y., Shinkyu Chiryo no Shinkenkyu [New Studies in Acupuncture and Moxibustion Therapies], Osaka: Sogen Sha, 1959. _ __, Shinkyu no Igaku [Western Studies of Acupuncture and Moxibustion], Osaka: Sogen Sha, 1956. _ __, Toyo Igaku Gaisetsu [Outline of Oriental Medicine], Osaka: Sogen Sha, 1961. Nagatomo, T., Nagatomo M.P. Shinkyu Kuowa Hachiju Hachisyu [Mr. Nagatomo's 88 Lectures on the Minus Plus Needle Therapy], Kyoto: Shinkyu Shinkuokai Sha, 1976. Omura, Y., Illustrated Lectures on the Bi-digital 0-ring Test, Yokosuka: Ido no Nippon Sha, 1986. Shiroda, B., Shinkyu Chiryo Kisogaku [Fundamentals of Acupuncture and Moxibustion Therapy], Yokosuka: Ido no Nippon Sha, 1978. _ __, Shinkyu Shinzui, The Basics of Acupuncture and Moxibustion, Yokosuka: Ido no Nippon Sha, 1977. Takagi, K., Seitai no Chosetsukino [The Control Systems of the Biological Organism], Tokyo: Chuokoron Publishing Company, 1972. Yanagiya, S., Shinkyu Ijutsu no Man [An Introduction to the Medical Arts of Acupuncture and Moxibustion], Yokosuka: Ido no Nippon Sha, 1948.

BOOKS IN WESTERN LANGUAGES:

Anon., Symposia Proceedings of the National Symposia of Acupuncture and Moxibustion and Acupuncture Anesthesia, June 1979. Baldry, P.E., Acupuncture, Trigger Points and Musculoskeletal Pain, Edinburgh: Churchill Livingstone, 1989. Barral, J.P., and P. Mercier, Visceral Manipulation, Seattle: Eastland Press, 1988. Becker, R.O. and A.A. Marino, Electromagnetism and Life, Albany: State University of New York Press, 1982. Becker, R.O. and G. Selden, The Body Electric, New York: William Morrow Company, 1985. Bischko, J., An Introduction to Acupuncture, Heidelberg: Haug Publishers, 1985. Bohm, D., Wholeness and the Implicate Order, London: Ark Paperbacks, 1980. Bourdiol, R.J., Auriculosomatology, Paris: Maisonneuve, 1983. Capra, Fri~of, The Turning Point, New York: Bantam Books, 1982. Chaitow, L., Soft Tissue Manipulation, Wellingborough, England: Thorsons Publishing Group, 1987. Davies, P., The Cosmic Blueprint, New York: Simon and Schuster, 1988. Diamond, J., Life Energy: Unlocking the Hidden Power of Your Emotions to Achieve Total Well-being, New York: Dodd, Mead and Company, 1985. Dossey, L., Space, Time, and Medicine, Boulder: Shambhala Publications, 1982.

Bibliography

431

Ellis, A. et al., The Fundamentals of Chinese Acupuncture, Brookline, MA.: Paradigm Publications, 1988. Foss, L., and K. Rothenberg, Second Medical Revolution, Boston: Shambhala Publications, 1987. Gleick, J., Chaos, Making a New Science, New York: Viking Penguin Inc., 1987. Harding Rains, A.J. et al., Bailey and Love's Short Practice of Surgery, London: H.K. Lewis and Co. Ltd., 1971. Hashimoto, K., and Y. Kawakami, Sotai: Balance and Health Through Natural Movement, Tokyo: Japan Publications, 1983. Kapel, P., The Body Says Yes, San Diego: A.C.S. Publications, 1981. Kapit, W., and L. Elson, The Anatomy Coloring book, New York: Harper & Row, 1977. Kinoshita, H., Illustration of Acupoints, Yokosuka: Ido no Nippon Sha, 1970. Lau, D.C., Lao Tzu: Tao Te Ching, London: Penguin Books, 1963. Lovelock, J., Gaia: A New Look at Life on Earth, Oxford: Oxford University Press, 1979. Lu Gwei Djen and J. Needham, Celestial Lancets: A History and Rationale of Acupuncture and Moxibustion, Cambridge: Cambridge University Press, 1980. Manaka, Y. and I. Urquhart, The Layman's Guide to Acupuncture, New York: John Weatherhill Inc., 1972. Mann, W.E., Orgone, Reich and Eros: Wilhelm Reich's Theory of Life Energy, New York: Simon and Schuster, 1972. Matsumoto, K. and S. Birch, Extraordinary Vessels, Brookline, MA.: Paradigm Publications, 1986. Hara Diagnosis: Reflections on the Sea, Brookline, MA.: Paradigm Publications, 1988. Nakatani, Y. and K. Yamashita, Ryodoraku Acupuncture, Tokyo: Ryodoraku Research Institute, 1977. Needham, J., Science and Civilization in China vol. 2, Cambridge: Cambridge University Press, 1956. Nogier, P., Handbook to Auriculotherapy, Sainte-Ruffine: Maisonneuve, 1981. _ __J

Nogier, P., From Auriculotherapy to Auriculomedicine, Sainte-Ruffine: Maisonneuve, 1983. Nordenstrom, B., Biologically Closed Electric Circuits, Sweden: Nordic Medical Publications, 1983. Prigogine,l. and I. Stengers, Order Out of Chaos, New York: Bantam Books, 1984. Requena, Y., Terrains and Pathology in Acupuncture, Brookline, MA.: Paradigm Publications, 1986.

Character and Health, Brookline, MA.: Paradigm Publications, 1989. Reich, W., The Function of the Orgasm, New York: Meridian Books, 1971. Rolf, I. P., Rolfing: The Integration of Human Structures, New York: Harper and Row,

---J

1977. Schoffeniels, E., Anti-Chance, New York: Pergammon Press, 1976. Schonberger, M., The I Ching and the Genetic Code: The Hidden Key to Life, New York: ASI Publishers, 1979.

432

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Tae Woo Yoo, Koryo Sooji Chim: Korean Hand Acupuncture, vol. 1, Seoul: Eum Yang Mek Jin Publishing Company, 1988. Ulett, G. A., Principles and Practice of Physiologic Acupuncture, St. Louis: Warren H. Green, 1982. Unschuld, P., Medicine in China: Nan Ching, the Classic of Difficult Issues, Berkeley: University of California Press, 1986. Voll, R., Kopfherde Diagnotik und Therapie mittels Elektroakupunktur und Medikamentestung (Diagnosis and Therapy with Electroacupuncture and Medication Testing), Mediz. Liter, Verlag-gesellschaft, 1974. Walther, D. S., Applied Kinesiology, Pueblo, CA: Systems D.C., 1976. Wilber, K. (ed.), The Holographic Paradigm and other Paradoxes, Boulder: Shambhala Publications, 1982. Worsley, J.R., Traditional Chinese Acupuncture, Vol. 1: Meridians and Points, Tisbury, England: Element Books, 1982. PAPERS

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INDEX A abdominal aorta: 134 abdominal distension: 230 abdominal pain: 45, 99, 134, 149, 167, 230, 267, 269, 279280, 282, 318-319, 321, 406407 abdominal palpation: 89, 120, 127, 131, 133-134, 136, 141, 143-144, 159, 162, 319, 400 abdomen, healthy: 136 abdomen, thin: 128 acne:232 Acrasiales amoeba: 20 acupoint: 6, 10, 14-15, 19, 25, 28, 31, 36-37, 43, 49-53, 5661, 63-66, 71-75, 77-78, 82, 84, 87-95, 101, 103, 105-107, 111, 118, 160, 223, 233, 235, 252,254-256,311,314,318319, 323, 325, 328-329, 331333, 344-345, 348, 350-352, 355, 363, 366-367, 372, 389, 396-397, 401, 403-404, 409410,416,422 acute conditions: 148, 155, 160, 235, 242 Akabane testing: 329

akashi-based diagnosis: 114, 152 allergic rhinitis: 220, 232, 317 allergic skin conditions: 254 alopecia: 232, 270, 344 alternating hot and cold: 160 amenorrhea: 54, 239, 332, 343-344 analgesics: 136 anemia:245,259,269 angina:213,268,271,315 anosmia: 216 anti-bias: 32-33 appetite, poor: 195, 209 apoplexy: 129, 259, 316 appendicitis: 141, 214, 280, 311-312, 316

arm jue yin channel sinew: 150 arm shao yin channel sinew: 150 arm tai yang channel sinew: 150 arm tai yin channel sinew: 76, 150 arm yang ming channel sinew: 150

hi-digital 0-ring test: 25, 93, 128, 134-135, 141-142, 144145, 151-153, 166-167, 181, 189,212,243,265-266,272273,278-283,288-289,291293, 295-296, 306, 324, 326, 399, 405-406, 411, 416-417, 422-423 bihourly supplementation: 132, 167

arrhythmia: 230, 315

biliary tract ascariasis: 315

arthritis: 144, 147, 193, 211, 216, 231, 240, 272, 276, 290, 317,406

biliary tract infection: 315

ASIS region: 137, 161, 171, 268

biometeorology: 33

biological system: 18-19, 30, 112,400

associated-shu points: 183184, 266, 273 asthma: 10-11, 145, 150,209, 212-213, 221, 230, 236, 244, 259,285-288,312,351 astigmatism: 215 auriculomedicine: 12 16 79 244,397 I

I

I

auriculotherapy: 11-12, 16, 73, 79,90,117,244,344,397 autonomic nervous system: 221,254,257,332

ba gang bian zheng: 10, 115, 176,309

B back-shu points: 137, 142-

biorhythms: 10, 19, 28, 58, 66, 68-69, 87, 89, 99-101, 103106, 112-113, 116-117, 151, 159, 166-168, 180,367, 371, 392,423 biorhythmic treatment: 99, 103-106,116-117, 159,166, 168,371 biorhythms and five phases: 99 Bischko: 79 bitter taste in the mouth: 167 BL-1: 85, 233-235, 240, 359, 365 BL-2:188,234,238,240,359 BL-4: 234-235 BL-5: 234, 359

143,147,158,166,223,311

BL-6: 173, 234, 359

bacterial infections: 129

BL-7: 188, 234, 316

Baldry: 326

BL-8: 234, 359

Becker: 31, 37, 52, 79, 397, 415, 421-422

BL-9: 188,234,359

Bell's palsy: 149, 217, 231 Benoit: 28, 423 beri-beri: 216 bias: 7, 12, 27, 29, 32-34, 43, 84-85, 124, 130, 132, 157, 165, 179, 181, 196, 205, 218, 228, 245, 261, 306, 324, 339-340, 397

BL-10: 188-189, 193, 209-210, 213-217, 233-234, 236, 239240, 255-256, 359 BL-11: 50, 188,213-214,216217,237,317,359 BL-12: 85, 188,209, 213-217, 237-238, 253 BL-13: 94, 142, 184, 212-213, 215, 234, 237, 240, 253, 266, 285-288, 314

438

Index

BL-14: 142, 184,213-214, 234, 253,297

BL-34: 187, 194, 352

blackbox: 55, 79

BL-35: 50

BL-15: 142, 184, 213-217, 234, 240,253,289,315,359

BL-36: 50, 359

BL-17: 177, 184, 194-195, 212-216, 237, 239-240, 285286, 305, 333-334, 337-338

BL-38: 295

bladder channel: 7, 50, 53, 60, 67, 73, 76, 78, 93-94, 97, 100, 104-105, 168, 225, 235, 272-273,277,281-282, 301, 359, 406, 411

BL-18: 72, 137, 142, 177-178, 184, 186-187, 189, 194-195, 200, 203, 206-210, 213-217, 234-235,237,239,253,255257, 266, 273, 283, 291-295, 297, 303-304, 307, 315, 317, 405-406 BL-19: 142, 184, 187, 214, 216, 234, 237, 289-290, 303, 305,315 BL-20: 142, 177-178, 184, 187, 194-195, 207, 209-210, 212216,228,234-240,253,256257, 269, 287-288, 292, 303, 315,317 BL-21: 142, 184, 187, 214-215, 236-238,240,291-294, 303305,311 BL-22: 142, 184, 187, 210, 214-216, 235, 237, 239, 256; 292-293, 303, 305 BL-23:94, 139,142,161,176178, 184, 187, 189, 193, 200, 207-210, 213-216, 234-240, 253, 256-257, 266, 269-270, 273, 276, 283, 285-288, 293294, 316-317 BL-25: 142, 184, 187, 189, 193, 208, 210, 212, 214-216, 234-236, 238-240, 253, 256, 265-266,269-271, 273, 289, 293-294

BL-37: 208, 216, 314, 359 BL-40: 89, 97-98, 100, 103, 187,194,206,211,234,236, 238-240, 256-257, 314, 359 BL-42:94,142, 184,215,300 BL-43: 142, 184, 207, 209-210, 212, 235-236, 256 BL-44: 142,184,315 BL-45: 315 BL-47: 142,184,186-187,295 BL-48: 142, 184 BL-49: 142, 184 BL-50:50, 142,184,214,315 BL-51: 142, 184, 187, 214, 235,268 BL-52: 94, 142, 177-178, 184, 187, 210, 212, 215, 234-236, 239,253,256,265-266 BL-53: 142,184,214,216,235 BL-54: 168,234,240 BL-55: 187, 240 BL-56: 140, 187, 359 BL-57: 140, 187, 234, 239-240, 288 BL-58: 140, 187, 190, 194, 200,208,210,256-257 BL-59: 85, 215-216

bladder problem: 253, 272, 277,281,295,354 bladder tuberculosis: 214 blockages of the blood vessels: 13 blood: 13, 42, 49, 65-66, 70, 82, 85, 87, 118, 128-130, 137, 143, 150, 153, 162, 179-180, 182,203,209,221,228,237242, 246, 261, 267, 279, 298, 305, 307, 315-316, 324, 333341,344,349-354,388 blood coagulation: 129, 351, 354 blood pressure: 42, 153, 162, 209, 221, 238, 240-241, 279, 315-316 blood stasis: 128-130, 137, 153,179-180,182,203,228, 237-239, 241-242, 246, 261, 267,298,305,339-341 blood transfusion: 129 blood-clearing medicinals: 246 bloodletting: 3, 116-117, 129, 148, 158, 168, 203, 206, 240242,246,307 blue-colored superficial veins: 129

BL-60: 89, 97, 103, 169, 214, 216, 238-240

body organs: 391

BL-26: 240

BL-61: 85

body palpation: 133

BL-27: 142, 184, 186-187, 189, 215-218, 234-235, 240, 273, 290,305,315,317,406

BL-62: 11, 85, 159-161, 171175, 240, 268-269, 290, 292, 294, 3001 359

body structure: 18, 34, 82, 84, 106, 111, 118

BL-28: 142, 184, 186-187, 228, 239,291,407

BL-63: 85

body types: 391

BL-64:92, 168,171,175,190

Bohm:24,37,418,423

BL-30: 240, 359

BL-65: 89, 94, 97, 100-101, 103,164,168,181,233,238, 272,277,291,406

bonesetting: 197

BL-31:215,287,352 BL-32: 176-178, 187, 194, 210, 213-216, 219, 234, 237, 239, 253-254,257,317,352 \L-33: 176, 187, 214-216, 257, 352

BL-66: 89,97, 103,168,180 BL-67:89,94,97, 101,103, 164, 168-169, 215, 257, 272, 277,291,365,406

body tissues: 65, 125, 391

Bourdiol: 79 Boyd:21 bradycardia: 315 brain point: 219, 221, 257, 307

Index

breast pain: 215 broken bones: 231, 254, 256

channel therapy: 10, 114, 116-117, 156, 423

bronchiecstasis: 167, 314

channel trajectory on the hands: 225-226

bronchitis: 145,209,213,230, 237, 312-314

chaos:28,37,419-420,423

439

common cold: 209, 213 comparison of the abdominal quadrants: 136 conception vessel: 82

chest pain: 230

confluence-jiaohui points: 10, 68, 82, 99, 105, 112, 120, 138, 159,161,171,256-257,324

Chiba: 15

congestive heart failure: 129

child: 5, 9, 94-98, 102, 140, 144,163,215,282,285,306, 366,392,395,398,403-407, 410 childbirth: 179-180

conjunctivitis: 206, 215, 232, 406 constipation: 195, 210, 214, 230, 236, 254, 256, 260-261, 268, 302, 315

Capra: 17

childhood pertussis: 215

constitution: 178,332

cardiovascular system: 31

childhood polio: 215

carotid pulses: 131

chong mai: 83-85, 138, 146,

contracted feeling in the center of the chest: 150

bruising: 129, 253 bursitis: 218

c callus: 130 cancer: 130,141,302,314315, 317, 352, 416, 423

carriers of biological information: 396 central nervous system: 76, 245,422 central nervous system, severe damage: 245 cerebral apoplexy: 316 channel acupoints: 14, 57, 59, 71, 73, 77, 84, 91, 100, 103, 106, 158, 188-191, 195, 282,311,331,370,403,408 channel biorhythm: 69, 99101, 103, 106, 168 channel clock: 66, 71, 99, 111 channel frequency relationships: 73 channel palpation: 89 channel pathway: 50, 61, 69, 87, 157, 225-226

Cheng: 11, 50, 58, 86

159, 162, 187, 265, 268-271, 275, 277, 295, 318 chronic gastroenteritis: 214 chronic shoulder and low back pain: 32

circulation, poor: 129, 179, 210,241

correct qi: 5 corrective exercises: 246 correspondences: 41, 43, 7172, 75, 87-94, 97, 100, 105, 107, 134, 143, 153, 157, 165166,184, 224-225, 258, 273, 318, 324-325, 363-364, 367373, 391-392,396-397

climatic patterns: 391

costal arch, narrow: 128

closed circuits: 18, 126

cough: 160,230,236,259

coherent light waves: 396

counter-bias: 33-34

cold: 5, 134, 145-150, 153, 160, 176, 183, 209-210, 213, 236-241, 257, 266, 285-286, 309,343,349,351-352,354

counter-engendering: 392393,395,409

cold feet: 145-146,257

counter-restraining: 392, 394-395, 409

circadian: 66, 71, 100-101, 111-112, 181, 373, 400 circuit flow: 60, 65-66

channel sensitivity: 193

cold in the cheek muscles: 149

channel sinew symptomologies: 145, 148

coldness or achiness in the lower back: 146

channel sinews: 49, 58, 73, 75-78, 116-117, 145, 148-150, 183-184, 197

colitis: 171

channel software: 54-55, 5859, 61,79 channel stretching: 75, 191, 205,212,219,243,307 channel system: 10, 12, 18, 43, 49-80, 88, 106, 118, 156, 323, 398, 401, 410

contusions: 206, 208, 227228, 231, 242-243, 253, 256, 298

color: 47, 54, 87, 91-93, 119, 128, 130, 136, 150, 158, 161163, 165-166, 182, 241-242, 257, 261, 277-279, 363, 367, 391,401,404-405,408,411 color-phase correspondences: 91 combinations of points and colors: 92

counterflow qi: 160, 194

cramping: 148-150 cramping and epilepsy: 149 cramping and pain of the sexual organs: 149 cramping at the little finger: 150 cramping at the top of the big toe with pain: 149 cramping below the navel: 149 cramping between ST-12 and the cheek: 149

/

440

Index

cramping in chest: 149-150 cramping in knee region: 148 cramping in the neck musdes: 150 cramping of the abdominal muscles: 149 cramping of the lateral knee muscles: 148 cramping on the medial side of the thigh: 149 cramping on top of the big toe: 149 cross syndrome: 137-139, 146, 152, 161, 167, 180, 187, 223, 266-270, 273, 275-276, 279-280, 305, 325

C"-13: 181,214,216,234235,237,239

diagnostic methods: 114, 118, 127, 329, 332-333

C"-14: 74, 102, 134-135, 137, 164, 181, 209-210, 212-214, 216-217, 280,291-292,306307,370

diagnostic palpation: 89, 114, 127, 132-134, 136, 138, 142-143,151,153,161,195, 405

C"-15: 102,105,181,302, 360

diagnostic points: 11, 31, 52, 62-64, 74, 92-93, 96, 100-101, 104-105, 115-117, 125, 134, 140,142,144,151,157,161, 163-164, 166, 168, 171, 181, 184, 188, 311-313, 318, 325, 328,333

C"-17: 9, 74, 134-135, 137, 139,153,161,164,181,208210, 212-216, 234-236, 267, 270, 289, 360, 365 C"-21: 181, 281-283 C"-22: 10-11, 85, 142, 161, 216,233-237,243-244,318 C"-23:85,233-234,365

diarrhea: 160, 210, 214-215, 230,236,302,305,351-352 diarrhea in nursing child: 215

cupping: 3, 116-117, 148, 203, 241-242,246

C"-24:83,85,234,365

dietary problems: 157,237, 246,256,261

curvature of the spinal vertebrae: 148

cycle: 87-88, 91, 93-94, 96, 98, 101, 111, 392, 420

difficult labor: 215

C"-1: 71, 83-85, 234, 360

cystitis: 176, 215, 227, 231, 267,316

C"-2: 78, 181, 215, 235, 253, 257, 306-307 C"-3:74,78, 134,176,181, 210, 214-216, 234-236, 239, 253,281-283,316,360 C"-4: 74, 78, 134-135, 166, 178, 181, 194-195, 208-210, 212, 234-237, 239-240, 253, 257,278,342,405-406

D dai mai: 29, 68, 81-83, 85, 120, 139, 146, 159, 161, 187, 228, 270-271,275,279,290 daily branch method: 101 daily rhythm: 99-100, 102103, 168, 180

difficult menses: 215 difficulty bending and straightening the knee.: 148 difficulty breathing: 150 difficulty moving: 150, 217 difficulty moving the shoulder: 148 difficulty turning the head to right and left.: 150 digestive problems: 130, 146, 194,243,256,274

C"-5: 74-75, 78, 134-135, 181, 360 C"-6:61,78, 177,181,214216, 235-237, 239, 281-282, 289, 302, 315, 360 C"-7: 78, 178, 181, 194-195, 214-215, 235, 253, 279-280, 317,360 C"-8: 78, 236-237, 239, 352, 360

de qi: 185, 218

direct moxa: 72, 148, 166, 176-177, 181, 184, 187-188, 203,227,252,286-290,293, 303-304, 307, 351

deep body temperature: 328-329,341-344

direction of flow: 49, 55, 6063, 111, 365, 403

deformity at the side of the mouth, sudden: 149

directional polarities: 60 discoloration of an area: 129

C"-9: 78, 181, 213-215, 234235,237,282,360

degenerative diseases: 130, 227

disease patterns: 137, 159, 254, 341, 391

C"-10: 78, 153, 181, 234, 237, 253, 265, 292

degranulation: 37

diverticulitis: 141

dermatitis:232,240,279,307

dizziness: 146

C"-11:181,237,315

dermatome: 34, 117, 143, 240,323-324,331,351

D.N.A.: 5, 23, 112, 364, 366, 371-373

C"-12: 74, 78, 134-135, 137, 164, 166, 177-178, 181, 194, 207,209-210,212-216,234240, 253, 257, 274, 279, 281, 288, 294, 297, 302-303, 305, 315, 365-366

danokyu:203,242 daoyin: 75, 78 Davenas: 37

diabetes: 216, 231, 240, 259, 274,316,353 diagnostic confirmation: 132, 143, 159

drainage: 7-8, 43, 60-61, 6364, 79, 94-98, 100-102, 111, 115, 140, 145, 159-160, 163164, 166-168, 241, 366,376, 388,403

Index

dreams: 231 drllikll1g:59, 155,352 dryness: 5, 129 du mai: 29, 49, 64, 71-72, 81-

electrostatic adsorbers: 19, 31, 102-103, 113, 119-120, 122, 125, 132, 136, 144-145, 159, 161-164, 265-266,272273,277,279,288-292

441

five-phase theory: 2, 18, 30, 87-91, 93-94, 97, 105-106, 114, 365, 391-392, 408-409 flaccid muscles: 128, 134, 162, 267, 308

82, 85, 146, 148, 159, 185, 193, 228, 242, 255, 259-260, 268-269, 295, 361

embryogenesis: 18,27-29, 44,81,83,346,400,415

duodenal ulcer: 214, 230, 312-313, 315

emotions: 5, 32, 87, 129, 158, 194,232,257,324,326,391, 408

dysentery: 315

endometritis:215,317

folliculitis: 232

dysmenorrhea: 115, 195, 259, 317

engenderillg cycle: 88, 92, 94-96,111,392,398

food allergies: 256

dyspepsia: 230, 315

enteritis: 210, 230, 237, 259, 306,315

four examinations: 127

.E ear and eye problems: 146 ear, nose, and throat problems: 145 ear pain: 150 early stages of catching cold: 146 earth phase: 28, 87, 89, 9192,97,363,391-392 eczema:210,217,232,240 edema: 129, 143, 183-184, 237,340 Eigen: 23 ejaculatio praecox: 230 electrical fields: 79, 396 electrical characteristics of the channels: 52, 55, 416

flat wart: 232 flow of qi: 10, 65, 84, 96, 365, 402 flu:5, 147-148,241,307

formulating a diagnosis: 127

enuresis: 215

fretful child: 215

epilepsy: 146, 149, 209, 216, 316

Fujita: 53, 73-75

epistaxis: 206, 232 esophagealspasms:214 evolution: 14, 18, 23, 26-30, 53, 55-56, 79, 85, 106, 112, 344,393,411,417,422-423 extraordillary vessels: 10-11, 18, 36, 49, 57-58,61, 79, 8186, 89, 99, 105-106, 111-112, 114, 116-117, 120, 122, 128, 130, 137-138, 141-142, 145, 153, 156, 159, 161-163, 166167, 169, 171, 178, 182, 187, 223,259,269-270,404-405 eyes, illability to close: 149

E

Fukaya: 205-206, 244, 253, 303 functional diseases: 33, 76, 113, 130, 332-333 functional hyperesthesia: 141-142 functional hyposensitivity: 142 functional muscle groups: 75-77 functional uterine bleedillg: 231 Furukawa: 65-66

G

face problems: 146, 217, 236, 253

gallbladder channel: 53, 66, 69, 71, 78, 84, 128, 235, 273, 290,360

electrical moxa devices: 252

fatigue: 115, 119, 146, 194, 253-254, 280, 352

gallbladder problem: 146147,194,290,315

electrical potential: 121, 329, 416

febrile condition: 7, 129, 146148,242

gallstone: 168, 214, 231, 267, 270, 276, 313

electrical resistance: 25, 219, 325,329,345

fire needle: 3, 76, 143, 183184, 191-192, 195, 197-202, 212,219,243,307

gastric spasms: 214

electrical current: 121-122, 124,126,366,381,387,396, 400-401, 410

electrodermal: 79, 97, 117, 219, 222, 227, 271, 328, 345, 366,398-399,410-411,422423 electromagnetic: 30, 37, 53, 71, 120-121, 153, 324, 326, 381, 387-388, 396, 413, 416418, 421-423

five phases: 4, 19, 28, 36, 87108, 111-112, 117, 133, 159, 168,188,223,324,327,339, 363-366, 373, 391-413,419420 five-phase points: 64, 71, 82, 88-89, 91-93,95, 98, 106, 111, 117,156,165,396,421

gastric ulcer: 114, 230, 311313, 315 gastritis: 153,167,210,230, 237, 259, 315 gastrocnemius palpation: 140 gastroenteritis: 214 gastroilltestinal problems: 147,230

442

Index

gastroptosis: 210, 214, 230, 237,256,315

GB-31: 64, 84, 178, 208, 216, 253,255

GV-3: 214-216, 235-236, 239240, 287-288

gastrospasm: 315

GB-32: 360

GV-4:214-215,235-236,239

GB-1: 234-235, 360, 365

GB-33: 240, 360

GV-5: 235

GB-2: 188, 206, 216-217, 233, 237-238 GB-3:215,234,360

GB-34: 89, 103, 168, 178, 194, 198, 206-208, 211, 213-217, 234, 237-240, 253, 255-257, 298,315

GV-6: 361

GB-4: 235 GB-5: 215 GB-6: 235 GB-7: 188, 235 GB-8: 234-235 GB-9: 235 GB-10: 234-235

GB-35: 64, 84-85, 232-233, 243,257,301 GB-36: 213, 315 GB-37: 140 GB-38: 89, 94, 101, 103, 164, 168-169,237-238, 289, 300

GB-11: 234-235

GB-39: 194, 234, 238, 243, 253, 257, 299-300, 407

GB-12: 188,206-207,216-217, 235-236

GB-40: 92, 169, 178, 194, 208, 235,240,253,257

GB-13: 85, 235

GB-16: 215, 235

GB-41: 11, 68, 82, 89, 103, 105, 159-161, 168, 171-175, 206, 209, 214, 216, 233, 237, 240,266-271, 279, 291-294, 299-301, 304, 315-316, 405, 407

GB-17: 72,213, 216, 235

GB-42: 105, 360

GB-18: 235, 360

GB-43: 89, 94, 101, 103-104, 164,168,289,300

GB-14: 188,219,234-235, 238,240 GB-15: 235, 360

GB-19: 235 GB-20: 71-72, 188, 193, 207, 209, 212, 215-216, 233-238, 240,255,289,291

GB-44: 89, 103, 168, 257, 365

GV-8: 201, 216-217, 292-294 GV-9: 213-214, 216 GV-10: 188,201,213-214,361 GV-11: 316, 361 GV-12: 177-178, 185, 187-188, 190, 194, 201, 206-207, 209210, 212-217, 235, 253, 257, 287 GV-13: 234 GV-14: 53, 61, 72, 188-190, 193, 209, 213, 215-216, 234238,240,244,286-287,289, 291,294,314 GV-15:85, 188,361 GV-16: 85, 216-217, 234, 236, 238,361 GV-17: 234,361 GV-18: 361 GV-20: 71-72, 136, 178, 188, 194,207-210, 212-214, 216217, 233-238, 253, 255-257, 365

GB-22: 360

general treatment: 113, 115118, 137, 143, 145, 148, 151, 153, 156, 158-159, 161-162, 165-167, 176-177, 179-183, 193, 203, 205-206, 223, 227, 233, 244-245, 255-257, 265283,285-308,367,370

GB-24: 74, 134-135, 137, 139, 161, 164, 289

genetic information: 23, 30, 112

GB-25: 74-75, 134-135, 214215,235

geomagnetic field: 33, 104, 416, 422-423

GB-26: 64, 85, 135, 137, 139, 145,161,164,167,171,239, 266, 269-270, 274-276, 279, 299, 317, 319, 407

geometry: 19,28,37,98,420, 423 glaucoma:232,270,317

GB-27: 85

Gleick: 37, 423

GB-28: 85

gonorrhea: 215

Hashimoto: 85, 195, 197, 203,326,389,405,407

GB-29: 85, 135, 137, 164, 209, 318-319

governing vessel: 82

headache and vertigo: 231

GV-1: 85,234-235, 240

headache: 71, 74, 231, 238, 296,322,333

GB-21: 85, 188-189, 207-210, 212-213, 217, 235-236, 240, 256,289,295,297,360

GB-30: 210, 216, 234, 238, 240,338

GV-2:214,235,256

GV-22:216,304,361 GV-23: 188,206,212,303 GV-24: 71,234,361 GV-25: 361 GV-26: 234-237, 240 GV-28: 85, 234 . gynecological problems: 145-146,194,243,253

H hara: 47, 79, 126, 133, 153, 182,244,261,325-326,353354,397,421,423

Index

heart attack: 129, 150

homeopathy: 20-21, 25, 3637, 326, 353, 389

443

hot needle: 76, 143, 325

information system: 18, 26, 35, 112-114, 118, 127, 183, 337,397,411,413-414

heart: 221, 397

HT-1: 239, 315

inherited predisposition: 129

heart problem: 70-71, 145146,162,181,213,253,265, 277

HT-2: 356

heart channel: 66, 69-70, 100, 102, 105, 128, 168, 225, 370

heart valve disease: 213 heat: 5, 72, 117, 149-150, 176179, 182, 186, 192, 198, 202, 209, 227, 236-240, 252, 258, 289, 291-294, 329, 340, 348, 350-352

HT-3: 89, 103, 169, 180, 216217, 315, 356 HT-4: 89, 103-104, 168,217, 315 HT-7: 89, 92, 94, 100-101, 103,164,168-169,207,209210, 213-214, 216-217, 234, 237, 240, 289, 315

heat-pain threshold response:329,331,333

HT-8: 89, 100, 103, 169

Heaven and Earth: 5, 87

HT-9: 89, 94, 100-103, 164, 168,289,365

HEENT problems: 146 hematuria: 70 hemiplegia: 129,254,257 hemmorhoids:254 hemolysis: 129 hemoptysis: 213, 312 hemorrhaging: 215 hemorrhoids: 145,210,214, 231,240,256,259,280 hepatitis:210,221,228,230, 276-277, 279, 315 herbal medicine: 13, 15, 176177,203,227,314,339 hernia:214,231,304 herpes zoster: 227-228,232, 240,270 high fever: 242, 352

hinaishin: 61, 205-206, 217218,376,389,407 Hirata: 128, 131, 143, 153, 180,232,235,245,258,260 Hirata Liver Zone: 128, 131, 143,180,232,258,260 holographic paradigm: 16, 24,35,91,418,423 home moxa therapy: 157, 194,245 home therapies: 155-158, 177-178, 180, 206, 245-262, 307

hyperesthesia: 141-142,308 hypertension: 152, 213, 230, 268,315 hypertensive medications: 136, 142 hyperthyroidism: 216, 231 hypertrophic rhinitis: 216 hypoesthesia: 141-142, 308 hyposensitivity: 130, 141142,333 hypotension: 141-142, 230, 269, 308, 315 hypothyroidism: 231

I imbalances of the autonomic nervous system: 254, 332 impotence: 149, 215, 230, 239,257,259 infection: 10, 147-148,213, 216, 230, 241, 307, 315, 350 infectious disease: 147, 230 inflammation of the canthi: 215

insertion of needles: 19, 389 insomnia: 146,195,208,231, 237,257,259,268,278,342, 344 inspection of the skin: 128 intercostal neuralgia: 208, 216, 231, 239, 312, 316 intersection-jiaohui points: 64-65, 71-72, 76,84-85, 112, 178,189, 193,232,~235, 243 intestinal cancer: 141 intestinal hernia: 214 intestinal invaginations: 141 intestinal problems: 145-146, 253 intestinal spasm: 315 intestinal TB: 141 intradermal needle: 61, 117, 158, 193-194, 205-206, 217219, 223, 227-229, 233, 243, 281,286-288,290-305,339, 343-344, 352, 376 intussusception: 214 ion beam device: 19,95-96, 105, 113, 119-120, 122-125, 132,1~145,151,159,161-

164, 268,271,273-277, 281282,306 ion pumping: 18-19,31,95, 102, 113, 119-122, 125-126, 140, 144-145, 158-159, 161165, 167, 171, 190, 193, 212, 227,232-233,244,246,265273, 275, 278, 283, 285-305, 307-308,404-405 ionic currents: 31, 121, 126, 396,415 iritis: 215

inflammation of the shoulder joint: 313

irritability: 257

inflammation of the spinal cord: 216

ischemic angina: 315

inflammation of tissues: 215

irritable bowel: 315 isophasal correspondences: 90,93

444

Index

isophasal relations: 157, 180 isophasality: 18, 28, 37, 8994, 99-100, 107, 111, 116, 156158, 168, 180-181, 183, 188, 190,219,223,244,327,366367,373 Itaya: 54, 130, 138, 153, 194195, 205, 219, 227, 244, 261, 306, 327-362, 397,411

J jaundice: 214 Jia: 103, 168, 355

jing: 3, 5, 7, 9, 14-16,25, 4952, 56-58, 77-82, 86-87, 89, 94, 103, 105, 116, 130-133, 160, 241, 243, 255-257, 307, 325, 328-330, 341, 343, 348, 355,363-374,388,391,411

jing luo: 49-80, 52-76, 116, 239, 325, 328, 411

jing luo theory: 49-51, 77-80 jing mai: 49, 86 jing xue: 14, 57

Kl-7: 67, 89, 94, 96, 98, 101, 103, 164-165, 168-169, 178, 194, 209-210, 238, 253, 257, 269-270, 272-274, 276, 281, 286,288,293-295,297,300, 342-343,358,370,404

194, 265-266, 271, 276, 283, 289-295,303-305,343,352

Kl-10:89, 100,103,168,180, 237 Kl-11: 7, 60, 85, 104-105, 135, 137, 139, 161, 164, 268-269, 272, 277, 281, 291, 318, 358, 406 Kl-12: 176,215,239 KI-16: 62, 64, 67, 72, 83-84, 92,96,98, 100,103-105,135, 137, 139, 141, 144-145, 152, 161, 164-165, 214-216, 235, 265, 267, 269, 271-274,276, 279, 281-282,285-289,291297, 300, 316, 318-319, 370, 404 Kl-21: 85, 358

Kl-25: 213

keiraku chiryo: 10, 35, 89, 116 keratitis: 215 Kl-1: 83-85, 89, 94, 96, 98, 100-101, 103, 164-165, 168169, 181, 214, 257, 272-274, 276, 281, 288, 293-295, 300, 317, 365, 404 Kl-2: 67,85,89, 103,168,358 KI-3: 72, 85, 89, 92, 98, 100, 103, 168-169, 177, 190, 207, 209, 213-214, 216, 234, 237240,316,371 KI-4: 190 Kl-6: 85, 105, 125, 137, 144145, 159-162, 171-175, 177, 240, 265, 267, 269, 271, 282, 285-288,290,304,308

Kyushin, Yurnoto: 7

kyutoshin: 176, 184-191, 193-

jue yin: 7, 56-57, 67-68, 70,

Katsurnata: 21, 375, 389, 417, 423

Kreb's cycle: 90, 99

Kl-9: 85, 216

KI-23: 135, 137, 164, 213, 289,370

K

koryo sooji chim: 223, 244

Kl-8: 85

josen: 219, 240, 295 142, 149-150, 180, 184

Korean hand acupuncture: 90,206

KI-27: 213-214, 216 kidney channel: 50, 57, 62, 67, 70, 72, 83, 92, 94, 96, 100, 102, 104-105, 130, 137, 180, 189-190,270,274,276,280282,311,358,370,404 kidney problem: 147, 180, 187,267,273,281-282, 293, 313 kidney qi vacuity: 238, 314 kidney stones: 141 kidney-large intestine: 103, 105, 137, 140, 152, 165, 187, 193, 265, 271-272, 274, 276, 281, 288-289, 293-295, 299, 302-303, 370 kinesiological: 25, 33, 78, 144, 311, 324 Kinoshita: 15 Kobayashi: 229,244

kong xue: 14

1 lactation, insufficient: 212, 215 large intestine channel: 51, 55, 59, 62, 67, 70, 73, 75, 91, 94, 102, 189-191, 235, 271, 274, 280-282, 297, 363, 365366,370,401 large intestine problem: 67, 189 laryngitis: 317 leg jue yin channel sinew: 149 leg shao yin channel sinew: 149 leg tai yang channel sinew: 76, 148 leg tai yin channel sinew: 149 leg yang ming channel sinew: 149 leg pain: 149 leukorrhea: 210, 231, 239, 317 LI-1: 55, 89, 91, 103, 107, 168, 206,209,356,363,365,367 LI-2: 51, 61, 63-64, 89, 94-95, 97, 101, 103, 164-165, 168, 272-273, 282, 288, 293-295, 297,300 LI-3: 89, 103, 169, 180 LI-4: 25, 31, 37, 44, 59, 61-64, 74-75, 77, 91-92, 95, 97, 104, 152, 168, 188-190,206-207, 209, 212-213, 215-217, 233235, 237-240, 253, 255, 292, 298, 304, 318-319, 342, 356, 365-367, 371, 401, 408 LI-5: 89, 103, 168, 240, 282

Index

LI-6: 61 LI-7: 214, 316 Ll-8: 61

liver-small intestine: 137, 140, 152, 165, 167, 171, 184, 187,273,275, 280,291-292, 296-298,300,302-303,306

445

LU-1: 55, 74, 92, 104, 134135, 137, 139, 141, 144-145, 152, 191, 212-213, 217, 232, 265, 269,271-272, 277,281, 285-287,289,291,318,355, 366,406

Ll-10: 188-190, 210, 212, 214, 216-217, 253, 255-257, 298, 300-301

loca1Urrflammation:147 local swelling: 129, 256

LU-2: 135, 137, 139,236, 355

Ll-11: 61, 63-64, 89-91, 94-95, 97, 101-103, 107, 164-165, 168, 177-178, 188, 190-191, 206-207, 212-217, 234-240, 253, 256, 272-274, 276, 281282,288,293-295, 297-298, 300,370

lordosis: 148

LU-3: 139, 191, 238, 355

Lovelock: 37, 419, 423

LU-4: 139, 191

low back pain: 32, 150,219, 239, 266,269,280-281,290291,295,299,313,317,343, 405-406

LU-5: 51, 89, 94, 101, 103, 164, 168, 213-214, 216, 232, 234, 236-237, 240, 272, 286, 291, 316, 355, 406

LI-13: 296, 300, 314, 356

low back problems: 32, 219, 266,269,300

LU-6: 209-210, 213-214, 216217, 232, 256

lower abdominal problems: 146-147, 288

LU-7: 51, 79, 105, 125, 137, 144-145, 159-162, 171-175, 206, 209, 216-217, 233-238, 240,253,265,267,269,271, 281,285-288,304,308

Ll-14: 85, 191, 296, 299-301, 407 Ll-15: 85, 188, 190-191,208, 212, 214, 217, 234, 236, 239240 LI-16: 85, 188 Ll-18: 188 LI-19: 188, 214, 234-235, 356 Ll-20: 188, 190, 216-217, 233235,238,240,317,356,365, 367 Li Ding Zhong: 52, 79,314, 325

1i Shi Zhen: 86 lifestyle modifications: 245 lifestyle, poor: 157

ling gui ba fa: 105, 171 Ling Shu: 3, 7, 50, 56-57, 75, 78-79, 145, 148, 183, 197, 348, 391

liu zi jue: 97 liver and gallbladder problems: 146 liver cancer: 315 liver channel: 32, 57, 72, 93, 128, 130, 140-142, 1~165, 180-181, 190, 212, 235, 257, 266, 273, 275-278, 280, 298, 301, 306, 308, 405, 408-410 liver problem: 25, 32-33, 57, 76, 128-129, 137, 142, 146147, 152, 165, 179-181,202203,214,218,228,235,244, 261, 265, 272-273, 275, 277278, 293, 298, 306, 314-315, 405

lower ribs and costal border region are distended: 128 LR-1: 89, 93, 103, 168, 180, 365 LR-2: 77, 89,93-94, 101, 103, 164-165, 167-169, 239, 273, 275, 277-278, 292, 296-298, 301,307,406 LR-3: 76-77, 83-85, 89, 92-93, 103, 142, 168-169, 178, 194, 199,208,210,233-234,236240,253-255,257,278,290, 342-343 LR-4: 89, 93, 103, 169, 178, 194, 207-210, 214-215, 235, 237,253-254,257,342-343 LR-5: 239, 287 LR-6: 239 LR-7: 195 LR-8: 89, 93-94, 101, 103, 164-165, 167-169,210-211, 214-216, 237, 239, 273, 275, 277, 292, 296-298, 301,307, 406 LR-10: 193,212 LR-11: 193 LR-13: 74, 85, 134, 180-181, 214,216,237,239,291-292 LR-14: 44, 64, 74, 85, 93, 134135, 137, 139-140, 161, 164, 180-181, 209-210, 212-214, 216, 237, 239, 273, 278, 293, 296,298,306,318-319,405406

LU-8: 89, 103, 169, 355 LU-9: 51, 89-90, 92, 94, 101, 103, 164, 168-169, 236-237, 272,277,291,316,406 LU-10: 37, 89, 92, 103, 168, 181, 236-237, 355, 408 LU-11: 89, 103, 169, 180, 240, 355,365-366 lumbago: 57, 194, 254, 266, 306,318 lumbar pain: 146, 210, 221, 235-236,248,256,405-406 lung channel: 55,59, 62, 76, 78, 92, 94, 101, 104, 115, 137, 160,164,187,191,226,232, 266, 281-282,355, 365-366, 406 lung problem: 145, 253, 277, 281 luo mai: 49-51, 77-80, 159, 189-190,235,328,364,367

luo points: 159, 188-190,235, 364,367

M magnet: 4, 18, 21, 25,31-34, 37, 44-47, 53, 61-65, 75, 77, 91,95-96,99-100, 113, 119, 121-124, 132, 151, 158, 179182, 246, 279-280, 305, 324, 329,345,366,375,382-383, 385-389, 396,401,403-404, 413,415-419,422-423

446

Index

magnet heater: 34, 179-180, 246,279-280, 305 magnetic fields: 21, 121, 324, 329, 386, 396, 413, 416-417, 422

metronome: 71-73, 98, 101, 104-105,182,195,242,245, 255, 268, 277, 282, 288-291, 294

malignant tumors: 153, 245

microcirculation: 129-130, 228,327,333-338,340,361

Manaka mu points: 135, 137138

microsystems: 90-91, 223, 325

Manaka san yin jiao: 99, 178, 181, 275, 279-280

migraine: 216, 231, 255, 260, 285,299,316,318

Mandelbrot: 28, 423

minimal stimulation: 18-19, 33, 43, 59, 65, 93, 107, 118, 121, 123-124, 155, 197, 302, 341-343,395,401,419,421

mapping particular patterns of reactive points: 143 Maruyama:53,244 massage: 7, 13, 196-197, 210211,257,293,349-350 mastitis: 212, 231 mathematical model: 391412, 420-421 Mawangtui: 56, 348

monosyllabic phonemes: 97 morning sickness: 215, 239, 317 mother-child relationship: 5, 9, 94-98, 102, 140, 144, 163, 215, 282, 285, 306-307, 366, 392,395,398,403-407,410

muscle testing: 206, 418 muscle tone: 150, 196-197 muscle-posture-channel relationships: 77 musculoskeletal: 116, 148, 156, 158, 193, 243, 256, 290, 326 musculoskeletal problems: 148,193,243,256,290 myocardial infarction: 315 myocarditis: 315 myopia: 219, 232, 240

N Nagahama: 15

nai jia fa: 103, 168 naizhifa: 101,167-168,171 Nakatani: 52,79,399

maximum-minimum energy relationships: 102

motor points: 311, 323, 326

Nan Jing: 3, 7, 9, 15-16, 57, 86-87, 89, 94, 131-133, 160, 366,391

McBurney's point: 79, 141

movement of qi: 83

nasal bleeding: 317

Medikamententestung:25

moxa, indirect: 183, 287-288, 350-351

neck stiffness: 193

Melzack: 16, 326, 402, 411 memory, poor: 195 menopause: 180, 210, 231, 239,241,317 menorrhagia: 317 menorrhalgia: 231 menses: 180, 210, 215, 227, 239,257,332 menses, irregular: 215, 239 menstrual cycle: 85 menstrual flow, incomplete: 129 menstrual pain: 195, 239 menstrual problems: 129130, 146, 194 mental disorder: 316

motion sickness: 231

moxa on the handle of the needle: 176, 183-185, 188189, 193-194,203,212, 228, 233,288,343,352 moxibustion: 3-5, 7-8, 10-19, 30,32-35,49,51-52, 56-57, 59, 65, 72-73, 77, 87, 106, 111112, 116-117, 121, 136, 143, 146, 148, 155, 157-159, 166167, 176-178, 181-195, 198203, 205-206, 210, 212-217, 219, 227-228, 233, 236-237, 239-240, 243-245, 252-253, 256, 258-259, 265-266, 268269, 271, 273, 276, 278-283, 286-295, 300, 303-305, 307, 314, 325, 327-329, 341-344, 348-355, 361, 382-383, 389, 406-407, 420 moxibustionists: 8, 12, 205

meridian imbalance diagram (M.I.D.): 18, 34, 36, 47, 85, 118, 130, 178, 221, 327329,332-333,341,346,361

mu points: 74-75, 133-135, 137-138, 143, 166, 278, 314, 318

metal phase: 67, 87, 89, 92, 94,366,391

Mubunryu hara diagnosis: 133

negative electrode: 102, 105, 136, 164 nephritis: 214-215, 230, 276, 316 nervous gastroenteritis: 230 nervous problems: 136, 146147, 254, 331-332 nervous system: 18,21-22, 25, 31, 43, 60-61, 76, 95, 98, 121, 143, 245, 254, 257, 324, 331-333, 376, 388, 398, 422 nervousness: 146, 268-269 neural dermatomes: 117,323 neuralgia: 10-11, 146,207208, 216-217, 231, 238-239, 306, 312-313, 316 neuralgia of the arm: 217 neuralgia of the inguinal joint: 216 neuralgia of upper arm: 217 neurasthenia: 316 neurological disorders: 196, 316

Index

neurological medications: 136

osteoarthritis: 317

Neurometer: 67, 399

ovarian cystoma: 317

neurophysiology: 18, 25-26

overcontraction and swelling of the neck: 150

neurosis: 145-146, 216

otitis media: 216, 306

neurotransmitters: 153

~

Nogier: 11, 16, 35, 73, 117, 217, 219-220, 222-223, 244, 325,344,348,397

pain and cramping: 149-150 pain, axilla: 148, 150

non-inserted needle: 186, 376

pain, chest: 134, 149, 230, 405

Nordenstrom: 31, 37, 126, 415,421-422

pain, chin: 150

north and south magnets: 44,46,75,91

pain, knee: 211, 232, 283, 288-289

north magnet: 25, 31, 37, 6263, 99-100, 182, 382-383, 385, 388, 403-404

pain, medial malleolus: 149

numbness of the arm: 217 nutrition, poor: 245

0 occipital pain: 217, 267 ocean of the blood: 82 ocean of yang: 82 ocean of yin: 82 octahedral model: 26, 47, 70, 81-86, 103, 189 octahedral relationships: 34, 331 octahedral structure: 81-82, 178 octahedral symmetry: 26, 28, 43,47 octahedral theory: 18-19, 29, 43,4~64,309,327,378,420

Chnura:25,32, 128,142,144, 153,324-326,337,399,403, 405,411,415-416,422-423 open point: 103-106, 159, 161, 166-169, 171, 173, 175, 180,265,267,286,289-290, 292-293,300-301,305,370 open ulcers: 217 organ-channel system: 49, 160 Oschman: 31, 37, 415, 421422

pain killers: 142

447

palpation, gastrocnemius muscles: 127, 137, 139, 143 palpation of abdominal points and areas on the abdomen: 89, 120, 127, 131, 133-134, 136, 141, 143-144, 159,162,319,400 palpation, radial pulse: 89, 127,131-132,137,143,314, 400 palpatory reflex areas: 391 palpitations: 134, 146, 208, 213,253,282 pancreatitis: 231-232, 238, 316 panting: 160

pain, navel: 45, 149, 278

paradigm: 24, 35, 91, 182, 244,326,397,411,418,423

pain, neck: 150, 193, 232, 296

paranasal rhinitis: 317

pain, olecranon process: 150

parotitis: 214

pain: 7, 11-12, 16-17, 31-33, 37, 43-47, 55, 59-64, 67, 7172, 74, 76, 79, 83, 91-93, 96100, 102-105, 107, 114-115, 118, 120, 122, 127, 130, 132, 134-137, 140-146, 148-150, 152, 156, 160, 162, 164, 166168, 176, 178, 180-182, 184, 187, 189-191, 193-198,205, 208-212, 214-215, 217-219, 221-223, 226-228,230-232, 234-236, 239-240, 243, 246, 248,253,255-256,260,265267, 269-270, 272-283, 288291, 295-297, 299-300, 302303, 305, 311-326, 328-329, 331, 333, 340-341, 343, 352, 364-367,370,384,388,401408, 410-411

pathophysiology: 337 pattern: 3, 24, 28, 33-34, 36, 44,63,69,76,87, 104,113114, 117, 127, 131, 135, 137138, 141, 144-145, 151-152, 155, 157, 161-162, 165-167, 171, 179, 184, 186-187, 189, 195,223,239,265-271,275277, 279-280, 282, 285, 306, 318,320-322,325,341,392, 406-407,418 PC-1: 135, 137, 139, 153, 161, 164,266,274 PC-3: 64, 84, 89, 103, 169, 233,253 PC-4: 64, 213, 216-217, 234, 253,315

pain, penis: 149

PC-5: 89, 103, 169, 234

pain, scapular region: 150

PC-6: 82, 120, 159-161, 167, 171-175, 208,210, 217, 234, 236-240, 255, 266-271, 278, 291-293,301-305,308,405

pain, shoulder: 32, 146, 148, 184,190,208,217,219,223, 228, 270, 275-276, 280-281, 283,288-289,296,406 pain, thigh: 149, 193 pain, tibia: 149 palpation: 60, 89, 114, 127, 132-134, 136-137, 139-143, 145, 151, 181, 187, 195, 212, 274,283,311,314-317,400, 405

PC-7: 64, 84, 89, 92, 94, 101, 103, 164, 168-169, 171, 175, 208,210,217,233,240,253, 315 PC-8:89, 103,168,317,356 PC-9: 89, 94, 101, 103-104, 164,168,356,365

448

Index

pelvic inflammatory disease: 147-148

polarities of needle direction: 378

pulse diagnosis: 8, 13, 47, 131-133

pendants: 42, 159

polarity agents: 18-19, 31-33, 54-55, 60-63, 65, 91, 95-96, 102-104, 106-107, 112-113, 119,122,138,144,156,159161,183,325,366,404

pulse,ilTegular:213

periarthritis humeroscapularis: 231 pericarditis: 315 pericardium: 6-7, 56-57, 59, 64, 67-68, 70, 72, 75, 78, 8182, 84, 89, 92, 94, 101-102, 132, 1~135, 142, 146, 153, 164,180,184,187,226,233, 242,255,274,297,301,303, 319,321,356,365,396-397 perineural: 31 peripheral circulating blood: 338 peritonitis:214,312,316 pertussis: 213, 215, 313 phantom function: 21, 417 pharyngitis:214,240,317 phasal characteristics: 89, 92, 107,365,396 phasal correspondence: 97, 368,396 phase cycles: 91, 94 phase, phasal: 24, 28, 49, 67, 70, 87-94, 96-101, 103-104, 106-107, 111-112, 116, 119, 133, 141, 159, 166, 168, 180, 188,223,324,363-371,391399,403-404,408-409,419420

polarity tests: 83

pulses: 8-9, 13, 16, 28, 47, 71, 89, 93, 100, 102, 104, 124, 127, 131-133, 137, 140-141, 143, 145, 150-152, 156, 158, 162, 167, 178, 181, 190, 206, 213,265-267,272-273,275-

positive electrode: 102, 105, 132,164

278,280,282,2~306,314,

postpartum discharge: 317

pulsings: 134

pre-disease conditions: 332

pyelitis: 215

pressure pain: 7, 12, 31, 33, 37,44-46,55,59-64,67,7172, 74, 76, 79, 83, 91-93, 96100, 103-105, 107, 127, 132, 134-137, 141-145, 150, 152, 162, 166-167, 176, 178, 181, 187, 189-191, 193-195, 212, 219, 231-232, 234-236, 240, 253, 278-279,283, 297, 311326, 328, 352, 364-367, 370, 401-408,410

pyelonephritis: 316

370,372,391,400,405-407

Q

pressure perspiration reflex: 26,43

qi: 5-6, 10, 13, 19, 35-36, 41, 43,47,49,58,65456,69,8184, 86, 89, 96, 112, 116, 136, 143, 146, 149, 155, 160, 177, 185, 194, 218, 237-239, 244, 255, 314, 327, 349, 365, 375, 386,388-389,396,399-402, 411, 413-414, 416, 419-420, 423 qi counterflow: 255

Prigogine: 23,423

qi gong: 5, 75, 78, 97-98, 181,

primary channels: 49-50, 57, 61, 66,75 primitive signals: 83 problems that come when sitting from a lying position: 147

197,375,389,418,423

qi jing ba mai: 81, 86, 116 qi jing mai: 49 Qigong: 75, 78, 97-98, 181, 197,375,389,418,423 quadrantality: 26, 43, 85-86, 341

pi: 6-7, 142, 184, 187, 303, 355

problems that come when standing from a sitting position: 147

Pelvic Inflammatory Disease (P.I.D.): 147-148

problems, urination: 145, 316

radial pulse palpation: 89, 132,400

pigmentation: 128-131, 136, 203,290,345,405

propagating sensations: 5253

pimples: 130, 227

prostatitis: 230

radial pulses: 8, 127, 131132,137,141,145,150,156, 158, 167, 314

pleuritis:213,312

psychological counselling: 157

pheromone: 20-21

pneumonia:213,312,314 Po Di Gao: 203 point reactions: 127, 153, 166,318,322 polar agents: 163 polar channel pairs: 83, 102, 122, 158-159, 161-163, 166

psychological problems: 129, 136, 146, 194, 216 psychosomatic disorders: 332 pulling pain at the lateral edges of the chest: 149

R

range of motion: 150, 193, 198-202, 206, 212, 218, 227, 246,272,283,291,297,406 reflex point: 7, 35, 57, 59, 63, 67, 71-72, 75, 77, 79, 90-91, 93, 100, 105, 117, 141-143, 145, 165-166, 180-181, 187, 232, 266, 281-282, 288-289, 302, 319, 324, 365, 367, 401, 407

Index

reflex points, tender: 59 reflexology: 34-35, 90-91 regeneration:22,37,351,415 regulation and distribution of qi: 81

ren mai: 29, 49, 64, 71-72, 8182, 85, 137-139, 141, 145, 148, 159, 161-162, 171, 181-182, 187,193,212,242,255,259260,265-267,269,271,280281,285,287,290,295,302, 318,360 ren mai-du mai axis: 29 renal atrophy: 215 renal calculi: 316 renal disease: 230 renal tuberculosis: 177, 214 Requena:326 respiratory disorders: 243

Sawada: 8, 177, 205-206, 213217

sayoshi: 21, 37, 375-390, 417, 423 scarring moxibustion: 178, 203 scars:27,32, 196,203,206, 228, 296, 350, 353 schizophrenics: 71

rhinitis:206,216,220,232, 240,282,306,317 right-brain pattern recognition:3,36 rings: 159, 196 river-jing points: 104, 160 root treatment: 113, 115-118, 137, 143, 145, 148, 151, 153, 156, 158-159, 161-162, 165167, 176-177, 179-183, 193, 203,205-206,223,227,233, 244-245, 255-257, 265-283, 285-308, 367, 370

Ryodoraku: 52, 79, 117, 244, 411

SI-1: 89, 103, 168, 365-366

scleritis: 215

Sl-2: 67, 89, 103, 169, 180

scoliosis: 148, 196

SI-3: 11, 89, 94, 99, 101, 103, 159-161, 164-165, 167-168, 171-175, 180-181, 188, 213, 233, 237-238, 240, 268-269, 273,275,277,290,292,294, 296-298, 300-301, 307, 406

scrofula: 217, 349 self-massage: 155 semi conductor network: 31 serious conditions: 162

sexual organ: 149 shaking of the leg: 149

san jiao: 6-7, 142, 184, 221

SI-4: 63, 92, 169, 190, 240, 278 SI-5: 89, 103, 168 SI-6: 217 SI-7: 188

shallowly inserted needles: 254, 376, 405-407

SI-8: 89, 94, 100-103, 164-165, 167-169, 240, 273,292, 296298, 300-301, 307, 406

Shang Han Lun: 7,146 shao yang: 7, 56-57, 67-68, 70,

SI-9: 139, 188, 192, 239-240, 289, 296-297, 356

75-76, 148, 150, 180

shao yang-jue yin: 180 shao yin: 7, 57, 67-68, 70, 149-

SI-10: 85, 139, 192, 216-217, 283,297,301

150, 180-181, 370

Sl-11: 188-190, 192,208,212215,217,297,317

shen men: 219, 221, 286, 301,

SI-14: 188, 236, 256

303-305

shi si jing: 49-50, 57-58, 79 Shi Si Jing Fa Hui: 50, 57-58, 79

Shinjutsu: 16, 153, 389 Shinkenkyu: 15 Shinkyu: 15, 79, 146, 213, 236, 244,307,354-355,361,411, 420,423 Shinkyu Rinsho Iten: 146, 244

~

shoulder problems,: 146, 180,189,191,227,236,242, 254,256,271,405

sciatica: 146, 208, 216, 231, 238,273,299,316,407

sexual dysfunction: 257

rheumatoid arthritis: 147, 211, 216, 231, 317

shoulder pain: 32, 146, 148, 184,190,219,223,228,270, 276, 283, 288, 406

shoulder stiffness: 254, 256

restraining cycle: 88, 92, 98, 100, 111, 392, 398

rheumatic heart: 315

shoulder, inability to raise: 148

shu ha ri: 15, 244, 309

restore the balance of qi: 155

retinitis: 216

shou po li: 15

Schoffeniels: 23, 30, 37

severe pain: 205, 227,280, 290

restricted movements of the shoulder: 254

449

Shiroda: 8, 177-178, 205-206, 213-217

Sl-17: 233 Sl-18: 188, 217, 234-235, 356 SI-19: 188, 206, 216,233-234, 237, 240, 365-366 signal: 18-27, 30, 32-33, 3536, 43, 47, 49, 58-60, 65-66, 73, 83,88-89, 96, 102-104, 106-107, 111-114, 117-119, 121, 125, 136, 144, 156, 158, 198, 309, 323, 325, 363-367, 370-373, 375-376, 398, 408411, 413-414, 417-419, 421, 423

450

Index

signal system: 18-20, 22-27, 30, 32-33, 35-36, 43, 47, 49, 58-60, 65-66, 73, 88-89, 96, 102-104, 106-107, 111-114, 117-119, 121, 125, 136, 144, 156, 158, 309, 325, 371, 373, 411, 413-414, 418-419, 421, 423

SP-6: 64, 71, 84-85, 194, 208, 210, 214-216, 232, 234, 236240, 243, 253-254, 256-257, 296-298,317,342-343,357

sprains: 208, 231, 242-243, 254,256

SP-7:210,232,256,357

ST-1: 85, 233-234, 240, 358, 365

single channel problems: 136-137

SP-9: 89, 101, 103, 169, 211, 237, 239-240, 303, 357

ST-3:85, 188,234-235

sinusitis: 216

SP-10: 64, 71, 84, 142, 178, 194, 210, 216, 239-240, 243, 253-254, 257, 283, 315, 317, 342

ST-5: 85, 214, 217

six character method: 97 skin problems: 217, 253 skin temperature: 329 skin texture and color: 150

SP-8: 210, 239, 253, 256, 298, 303-305, 316

ST-4:85,233-235,238

ST-6: 188, 233-234, 237-238 ST-7: 188, 214, 217, 233-234, 237-238, 240, 358

SP-13: 85, 139

ST-8: 188, 234, 238, 358

SP-14: 214

ST-9: 85, 139, 142, 161, 188, 209,213-214,216,358

SP-15:85, 139,279

small intestine problem: 100, 135,189,278,306

SP-21: 135, 137, 139, 145, 161,164,167,303

209-210, 245-251, 256, 288294,307,324,326,389,407

ST-2: 85, 238

SP-11: 316,357

small intestine channel: 53, 57, 67, 69, 78, 99-100, 135, 140-141, 181, 184, 189-190, 192, 218, 225, 275-278, 280, 283, 298, 300-302, 306, 308, 366,370

sotai: 85, 158, 195, 197-203,

spring-ying points: 160

SP-16:85, 139,357 SP-20: 357

spasming of the muscles around ST-32: 149

ST-11: 83, 161, 188, 289, 318319 ST-12:85, 139,142,149,161, 188, 190, 318, 358 ST-14: 314 ST-16: 314

Soulie De Morant: 323, 326

spasming of the muscles of the third toe: 149

ST-17: 358

source points: 82, 90-93, 103, 165-166, 168, 188, 190, 364, 367

spasming of the sole of the foot: 149

ST-19: 214

source-luo points: 189

speech disorders: 146, 307

source-yuan points: 52, 63,

spider veins: 129

ST-21: 135, 164, 214, 216, 232,237,303-304,315

67-68, 72, 75, 92, 160, 324

spinal extension problems: 147

ST-23: 78

south magnet: 25, 31, 63, 113,382-383,385,388,403404

spinal flexion problems: 147, 201,291

SP-1: 89, 103, 168, 180, 357, 365

spine and neck problems: 146

SP-2: 89, 94, 101, 103, 145, 164, 166-168, 171, 274-276, 299,407

spinal problems: 146-147, 216

SP-3: 89-92, 103-104, 166, 168-169, 190, 237, 279 SP-4: 82, 120, 159-161, 167, 171-175,210, 236-237, 239240, 266-271, 278, 291-293, 301-305, 308, 405 SP-5: 89, 94, 98, 101, 103, 145, 164, 167-168, 240, 274276,299,370,407

spiritual turtle eight methods: 105 spleen channel: 84, 100, 128, 130,145,167,189-190,225, 259,274-276,311,357,370 spleen problem: 145, 265, 275,370 spontaneous bleeding: 129 sprained ankle: 243, 256

ST-18: 304-305

ST-20: 315

ST-24:214-216,317 ST-25: 63, 72, 74-75, 78, 134135, 137, 139, 145, 161, 164, 166-167, 171, 178, 194, 207, 210, 234, 236-237, 239, 253, 257, 266-267, 269-270, 274276, 279, 291, 294, 299, 301302, 305, 315-316, 318-319, 407 ST-26: 63, 78, 100-101, 135, 137, 139-140, 152, 161, 164165, 167, 171, 266, 268-269, 273, 277, 280, 285-286, 289, 291-292,294,296-298,300301, 305-306, 317, 366, 370, 406

Index

ST-27: 31, 62-63, 67, 75, 91, 100, 135, 137, 141, 152, 161, 164-165, 167, 171, 194, 210, 214-215, 256, 265-266, 272274,280-282,285,288-289, 291-295,297,300-302, 304, 316,318,370,405 ST-28: 236-237 ST-29: 236 ST-30: 83, 85, 139, 142, 193, 239,358 ST-31: 193,212,358 ST-32: 139,149,290,316,358 ST-33: 358 ST-34: 209-210, 214-216, 283, 297,317 ST-35: 240, 358 ST-36: 89-91, 98, 103, 107, 169, 177-178, 206-210, 212217, 234, 236-240, 253, 256, 290, 297-298, 316, 378 ST-37:214,234,237,255 ST-38:239,256,342,358

stiffness in the back of the neck: 148 stomach atony: 214 stomach cancer: 315 stomach channel: 50-51, 55, 62, 102, 128, 137, 153, 171, 189, 212, 226, 232, 274, 311, 358 stomach hyperacidity: 214 stomach problem: 134, 146147,153,194,210,253-254, 275, 303, 314 stomach ulcer: 194, 214, 304, 314,331 stomatitis: 214

symmetry: 22-23, 25-26, 28, 33, 43, 47, 81, 111, 113 symptom control treatment: 115, 118, 156, 177, 203, 205245,252 symptom patterns: 131, 145146, 153 symptoms in confirming diagnosis: 145

systematic correspondences: 391

stretching exercises: 256

systemic microcirculatory changes: 65

stroke: 216, 219, 241, 257, 349

T

Su Wen: 3, 5, 7, 9, 16, 56-57,

ST-44:89, 103,168,176,232233, 237-238

swelling of the anterior portions of the thigh: 149

stress: 59,136,205,232,253254,256-257,269,285,302304,306,324,326

ST-40: 189, 235-239, 303

ST-43:89, 100,103,169,180, 240

swelling and pain of the fifth toe and heel: 148

systematic and comprehensive treatment plan: 18

structural disorders: 116, 156,183,195-197,246

ST-42: 92, 168, 189-190

sweating problems: 146

stream-shu points: 160

ST-39: 210, 237-238, 255, 315 ST-41: 89, 94, 101, 103, 132, 152, 164, 167-168, 171, 181, 206,235,240,256,276,304

451

tachycardia: 315 tactile examination: 127, 131

343, 348, 391

Tae Woo Yoo: 35, 117, 180, 217,219,223,244,299,325

subcostal reactions: 102, 153, 167,181,268,277

tai ji moxa: 253

subcostal tension: 33, 93, 102, 132, 137, 162, 171, 181, 273, 280, 291-295, 297,299300

tai yang: 7, 56-57, 67-70, 7576, 146, 148, 150, 180-181, 221,370 tai yang disease: 146

subcutaneous tissues: 136

tai yin: 7, 56-57, 67-68, 70, 76,

summerheat: 5

ST-45: 89, 91, 94, 101-103, 107,164,168-169,301,365

Sun Si-Mo: 13

149-150, 180-181, 188-189, 370 taikyoku: 176, 206, 232

stagnant liver qi: 314

sunken appearance: 128

Takagi: 26, 43

Stengers: 423

superficial invasion of cold or external qi: 146

TB-1: 89, 103, 169, 365

supplementation: 7-8, 60-61, 63-64, 79, 94-98, 101-102, 104, 111, 132, 140, 145, 159160, 163, 166-168, 181, 276, 366,388

TB-3: 89, 94, 101, 103, 164, 167-168, 171, 175, 233, 274276,299,407

sterility: 152, 210, 215 sternocleidomastoid musdes: 143 stiffness: 148, 150, 184, 188, 191,193,228,246,254,256, 272,283,289-291,406-407 stiffness and difficulty moving the tongue: 150

surgery: 10, 27, 79, 136, 179, 228,268,270,279,281,302, 306-307,316,331,405

stiffness of the fourth toe: 148

sweat rash: 217

TB-2: 89, 103, 168, 289

TB-4: 63, 72, 92, 166, 168, 171, 175, 177, 207, 214-217, 240,279,357 TB-5: 11, 68, 82, 159-161, 171-175,188,206,209,233, 236-238, 240, 266-271, 279, 291-294,301,304-305,405

452

Index

TB-6: 89, 103, 166, 168, 239240 TB-7: 357 TB-8: 64, 84, 178, 188, 194, 206-208, 213, 232-233, 253, 256, 301, 357 TB-9: 192, 216-217 TB-10: 89, 94, 101, 103, 164, 167-169,240,275, 299,370, 407 TB-13: 85, 188 TB-14: 188, 192, 239-240 TB-15: 85,192,213,216-217, 288-289, 291 TB-16: 235, 357

tetany of the muscles in the pectoral and anterior neck: 148 tetany of the posterior gluteal muscles: 148 thoracic: 53, 221,240, 259, 272,313,316,406 throat infection: 213, 216 thrombophlebitis: 317 thumb: 13, 18, 25, 31, 55, 5960, 95-98, 119, 132, 144, 155, 251,254,266,282,352,378 tilted uterus: 215 tinnitus: 150,216,232,237, 259

tuberculosis: 7-8, 177, 213214,230,312,314,353

tuina: 197 tumors: 130,153,227,245 twelve branches: 169 twelve channels: 7, 36, 50, 67, 69, 74, 81-86, 88, 94, 103, 106, 111-112, 145, 159, 168, 180,234,259 two-metal contact: 31, 83, 119, 122-123 typhoid fever: 242

u ulcer of the oral cavity: 317

TB-17: 188, 213-214, 216-217, 233, 235, 237-238, 240

tiredness: 146,254

ulcers: 130, 217, 237, 338, 351

tones: 97, 391

Ulett: 326

TB-18: 235, 357

tonsillitis: 209, 216, 317

TB-19: 235, 357

tonus, poor: 128

unidirectionality of channel flow: 18

TB-20: 188,235,357

tooth extraction: 221

uniting-he points: 160

TB-21: 188,206,235,230357

toothache: 33, 57, 145, 194, 207,214,221,235,237,253, 255

Unschuld: 14-16, 373,398, 410

temperature differences: 134,341

topology: 18-19, 27-28, 4243, 79, 82, 84, 106, 307, 361, 411, 420, 423

upper limb problem: 220

temporal relationships: 69

trachoma: 215

uranaitei: 176, 209-210, 214, 253, 286-288

ten-day channel biorhythms: 103

tranquilizers: 136, 142

urethral calculi: 316

transporting-shu points: 8889, 92, 94, 111

urethritis:215,316,406

TB-22: 215, 217, 357 TB-23:235,240,357,365

ten-day stem method: 103105 tension: 28, 31, 33-34, 37, 59, 71-72, 74, 76, 84, 93, 96-97, 102,127,132,134,137,141144, 150, 152, 156-158, 162, 171, 176, 181, 183, 187, 189, 191, 193, 195, 197, 203, 205, 212,219,227,236,246,254256, 266, 273, 277, 279-280, 291-295, 297, 299-302, 304306, 323, 325-326, 384, 401, 405-407 tension and pressure pain: 33,37,59, 76,132,162,193 ten-stem: 169, 396 testicular pain: 149 tetany of the muscles anterior to the femoral bone: 148

trauma: 115, 129, 179, 206, 254,256,273,290,296,298, 323 traumatic injuries: 254, 256 trigeminal neuralgia: 10-11, 146,207,217,231,238 trigger points: 16, 219, 311, 323-324, 326, 411 trigrams: 105,363-364,366367,369,371 triple burner: 6, 56-57, 59, 63-64, 67-68, 70-72, 75, 78, 81-82, 84, 89, 92, 94, 97, 101102, 132, 134-135, 142, 145, 164, 166-167, 171, 180, 184, 187,191-193,225,242,274276, 299-300, 303, 319-320, 357,365,370,397,407

unusual sweating: 146

urinary incontinence: 239, 316 urinary retention: 230, 316 urticaria: 221, 232 uterine bleeding: 215, 231 uterine cancer: 317 uterine prolapse: 317

v vacuities: 7, 13,94,96,100101, 113, 128, 141-142, 152, 157, 162, 177, 194, 236-239, 252-253, 269, 271, 273, 282, 290,309,314,348,366,395, 400,402-404,408,410 vaginitis: 285, 287-288 vascular spiders: 128-130, 241-242

Index

yin-yang balancing: 197, 203

vasomotion: 333-338, 340 venesection: 129, 158, 203, 241-242,246 vertical relationships: 18, 73 vesical calculi: 316 viral infections: 148, 242 visible raised venules: 128 visual examination: 127-128, 131,143 Voll: 25, 32, 52, 79, 117, 326 vomiting blood: 150 vomiting milk: 212, 215

w wakakusa: 185 water phase: 87, 89, 92, 94, 101,365-366,392,395,420

xiang: 5, 195

yin-yang channels: 137

xie qi: 5

yin-yang theory: 18, 39-41, 81,328

xin bao: 6-7 xin zhu: 6-7 X-signal system: 17-38, 4344, 47, 49-50, 58-60, 65-66, 73, 88-89, 96, 102-104, 106107, 111-114, 117-119, 121, 125,136,144,156,158,309, 325,339,367,371-373,375, 388,398,400-401,411,413414,418-419,421,423

y Yamashita: 79, 354

yang ming: 7, 56-57, 67-68, 70, 149-150, 180-181, 188-189

yang ming-tai yin: 91, 180

weakness, extreme: 155, 275, 308

yang patient: 128

wei: 11, 13, 49, 57, 65-66, 68,

yang qiao mai: 11, 85, 146,

82, 84-85, 137-138, 141-142, 146, 152-153, 159, 161-162, 167,171,184,187,228,265271, 275, 277, 290, 295, 318, 325,414

159, 161, 228, 268-269, 295, 318

well-jing points: 160

yang wei-dai mai: 137-139,

whiplash: 146, 207, 228, 236, 244

167 Yasumasa:21,375,389,417

wide costal arch: 128

Yi ]ing: 105, 355, 363-374

Wilber: 423

yin qiao mai: 85, 145, 159, 161-162, 187, 193, 265-267, 269,271,290,295,318

wind: 5, 236-238, 240, 285 Wiseman: 15 wood phase: 87, 89, 92, 94, 97, 364, 366, 391-392, 395, 420 wooden hammer and needle: 72-73, 100, 104-105, 192193,195,202,211,242-243, 253-254, 256-258, 282, 372 work habits: 155

453

yang wei mai: 11, 57, 68, 85, 137, 146, 159, 161, 187, 228, 265-267,271,290,318

yin qiao mai-ren mai: 128, 137, 139, 141-142, 144, 152, 162, 223,265,283 yin wei mai: 57, 85, 137, 141, 146, 159, 161-162, 187, 265267,269-271,277,295,318

yin wei mai-chong mai: 128, 137, 139, 142, 153, 162, 167

Yin Yang Shi Yi Mai ]iu ]ing:

Worsley: 79

56,348

wounds: 253-254,256,349, 351

ying: 13, 49-50, 58, 65-66, 69, 82,89, 103,355,365,376, 414,420 ying qi: 69, 365, 414, 420

yin-yang triplets: 146-147 Yoshiaki: 25, 415

yu yao: 219, 240 yuan qi: 5

z zangfu: 6 Zhen ]iu Da Cheng: 11, 50, 58 Zhen ]iu ]u Ying: 50, 58, 355 zhenggu: 197 zi wu: 69 Zi Yun Gao: 203

Yoshio Manaka, MD with Kazuko Itaya and Stephen Birch

Y

oshio Manaka was a poet, artist, scholar, physician, and healer. He lived for and was inspired by ideas and invention. At the pinnacle of his life he reached a level of healing skill that only those who have invested many years of practice, research, and study can achieve. Yet he sought not accolades, but hopeless and puzzling medical cases. He was not content with fame but sought bright young idealists to challenge and inspire. His transformation of East Asian traditional medical theory into a rational scientific model established the foundation for a new explanation of acupuncture, the X-signal system. It explains and explores both traditional and modern theories without trivializing either. He based every aspect of his model on clinical tests, observations, and years of successful clinical practice, both his own and that of a network of skillful and dedicated healers. Chasing the Dragon's Tail assembles the elements of that model, beginning with a clear exploration of the observational evidence. It organizes and presents Manaka's experim~tal and clinical findings, explaining each of the many levels. The system of theoretical explanation and clinical practice he evolved is detailed step-by-step with illustrations and instructions. Manaka's system is proven and practical, and is based on tests and observations every practitioner may confirm for themselves. It is an invitation not only to a new and dynamic understanding of acupuncture but to new levels of clinical skill. Chasing the Dragon's Tail ISBN-13: 978-0-912111·32-2