Reformation: a rational movement of the 21st century with the aim to reform outdated doctrines of 'alternative' medicines of the 20th century.
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Is Acupuncture a Religion?
[Do you study Chinese medicine?]
© Prof. (Dr. of Med.) Charles McWilliams 2009
Although not commonly thought of as a form of religion, the author, having practiced acupuncture for over thirty years and having written over ten professional manuals on the subject, contends that it is.
If we look at the usual definitions of religion, we see that ‘acupuncture’ conforms to all standards: religion (Random House Dictionary, 2009)
“1. A set of beliefs concerning the cause, nature, and purpose of the universe, esp. when considered as the creation of a superhuman agency or agencies, usually involving devotional and ritual observances, and often containing a moral code governing the conduct of human affairs.”
In this context, practitioners of TCM believe that there is a superhuman agency, called qi, and that as a matter of ritual observances, one must observe carefully monitor and control the will of the mind, the weather patterns, and diet in order to maintain health and promote it among others (the believers).
It is rather amazing in these days of licensed acupuncturists, how few have actually read the Su Wen and Ling Shu, or collectively, the Huangdi Neijing also known as The Inner Canon of Huangdi or Yellow Emperor's Inner Canon. It is an ancient Chinese medical text that has been treated as the fundamental doctrinal source for Chinese medicine for more than two millennia and should remain so today. It is comparable in importance to the Hippocratic Corpus in Greek medicine or the works of Galen in Islamic and medieval European medicine. I would think of an acupuncturist who has not made a study of these books comparable to a professed Christian who has not read the Bible, in its entirety, or of a “homeopath” who has not read (and re-read) Hahnemann’s Organon of Medicine. Simply, unconscionable.
In the antique age, man used to live according to the 'Tao', the 'Principle'. They used to observe the law of Yang and of Yin, to be sober, to live a regular and simple life. For this reason, health in body and in spirit, they used to be able to live up to a hundred years. Su Wen, Yellow Emperor’s Classic of Internal Medicine, Chapter 1.
When the Heaven is calm, the spirit, the will of man must be calm. If he is thus, his Yang energy will be powerful and the sicknesses will not be able to attack him. If he is, on the contrary, in opposition with the energy of the Heavens, the nine orifices will be closed, the pores of the epidermis will be disturbed and the energy will be dispersed. Su Wen, Yellow Emperor’s Classic of Internal Medicine, Chapter 1.
Thus we see the instructions to the acupuncture physician to live with the will of the heavens, a superhuman agency.
“2. A specific fundamental set of beliefs and practices generally agreed upon by a number of persons or sects.”
All forms of acupuncture, practiced to date in all countries, generally agree upon the principles of yin/yang, the five elements, and the pathways of the meridians; all of which are intangible, and cannot be measured. These principles are believed to be superhuman agencies that guide the destiny (health) of all individuals and nations.
“3. The body of persons adhering to a particular set of beliefs and practices:” e.g. a world council of acupuncture.
Since 1983, 18 World Congresses or International Symposia have been sponsored by ICMART (Vienna, Rome, Prague, Budapest, Istanbul, Copenhagen Miyazaki, Munich, Bath, Sofia, Cyprus, Riga, Berlin, Edinburgh, Sao Paulo, Sydney, Washington, Barcelona), with lectures, posters, workshops, and social activities. ICMART is a non-profit international organization comprising more than 80 acupuncture societies worldwide. It includes over 30,000 doctors practicing acupuncture and related techniques. There are, in addition, many acupuncture associations, groups, and councils, in many, many countries, all over the world.
And lastly, we find this fourth definition of “religion,”
“4. something one believes in and follows devotedly; a point or matter of ethics or conscience:” e.g. to make a religion of fighting disease.
The beginning of modern medicine started with the destruction of the vitalistic medical theories of the time. Practically all doctors in Europe at that time were Christian or Jewish in faith. In 1828, Friedrich Wöhler, a German physician and chemist by training, published a paper that describes the formation of urea, known since 1773 to be a major component of urine, by combining cyanic acid and ammonium in vitro. In these experiments the synthesis of an organic compound from two inorganic molecules was achieved for the first time. These results weakened significantly the vitalistic theory on the functioning of living cells. For this reason a sharp boundary started to exist between organic and inorganic compounds. Interestingly, Wöhler’s contemporaries, Liebig (the soil chemist) and Pasteur (the microbiologist), never abandoned vitalism and it took until 1845 when Kolbe repeated an inorganic - organic conversion of carbon disulfide to acetic acid before vitalism started to lose supporters in serious numbers.
Suffice to say, the German chemical industry would begin to dominate medicine. Bayer would synthesize aspirin, previously obtained from plants like willow. By 1899, Bayer's trademark Aspirin was registered worldwide for Bayer's brand of acetylsalicylic acid. Inorganic (synthetic) dye-making firms diversified by converting dye intermediates into pharmaceuticals, such as Sandoz's anitipyrin. Dyes were also employed in early biomedical research, particularly by Paul Ehrlich who began work in this field in the 1880's. Ehrlich used the dyes' color loss, or color gain, to explain reduction and oxidation processes in living cells. Sulfonamide drugs (prontosil, 1932) were the first antimicrobial drugs, and paved the way for the antibiotic revolution in medicine. This drug Prontosil, was discovered as a result of experiments with a bright red azo dye originally discovered by Caro in the 1860’s. No less significant were the studies on fermentation conducted just before World War I by the dye chemist Chaim Weizmann. Weizmann developed the acetone process, which came to be essential in the manufacturing of munitions for warfare, and coincidentally contributed to the birth of modern biotechnology. These developments led some of the early chemical companies like BASF, Bayer, AGFA, and Hoechst, and also in Switzerland, at the factories of Geigy, CIBA, and Sandoz, along with dye firms to engage in biomedicine, biotechnology, and the “life sciences,” fields in which they are now among the world leaders. Except for the continuance of Homeopathy, Herbalism, and Oriental Medicine, belief in vitalism would have all but ended.
The author contends, that any medicine using vitalism as a basis of diagnosis and treatment is a religion, by pure definition. It is amazing to know, how many doctors of medicine, fail to know how to actually define the definition of a “doctor;” and how many people, whom call themselves religious, cannot even define the word by its dictionary definition!
Vitalistic theories of medicine have been with us since time immemorial. There is no need to so quickly abandon what some may have no recognition of. Healing miracles occur every day of the week. We credit the major advances in surgery that has saved millions of lives, but physical medicine has plundered along for the last one hundred years and to date, still has no cure for the common cold, obesity and cancer.
Acupuncture, Medicine of the Sun, Moon, and Stars
To understand the underlying theory of acupuncture, it is tantamount to know the ideas and concepts of Chinese astrology-astronomy, the Chinese calendrical system, and feng shui (wind and water, or directionology). The Chinese people believe that ours is a world of cycles, and when our inner cycles (our biological clocks) are in synchrony with the cycles of the universe, we live healthier. When one is out of touch with these natural cycles due to the circumstances of living, the traditional Chinese people turned to the ancient practice of medicine as found in "The Yellow Emperor's Classic of Internal Medicine." Anyone carefully reading the Yellow Emperor’s Classic of Internal Medicine, effectively our canon of acupuncture, readily realizes this art was originally an astronomical and calendrical theology. It is axiomatic in Chinese medicine that all realms of nature, the macrocosm and microcosm, are interconnected inductively. The energetic processes of the Cosmos unceasingly modulate the physiological changes that take’s place in the organism. By knowing not only the climatic conditions, but also the positions of the sun, moon, planets and stars, the pathogenesis was understood, as well as the discrete points for selection to puncture. Only today has the West began to understand chronobiology, what the Chinese had curiously known since the most remote times.
Their cosmology is an astrology or the astronomy of universal correspondences from which all earthly manifestations proceed. Their deity so to speak, was the Kingdom of Heaven, the way, the Tao, from which all manifestations emerge. From the Chinese mentality we find a system of references connecting the macrocosm to the microcosm. They had their tables of correspondences. As for the meridian of astronomers, it makes a coordinate where celestial events occur on a chosen moment of time. As for the acupuncturist, it marks where celestial events modulate physiologic activities and the waxing and waning of energy through meridians at the sensitive points (shu-hsüeh) at a chosen moment of time. Cosmic meridian and biologic meridian tie together the same celestial combination - space/time - a phase of energy and activity. Viewing the cosmic meridian as horizontal and the biologic meridian as transversal may be of service in this regard.
From very early times, Chinese astrologers divided the sky into five ‘palaces’. They knew well the course of the planets around the sun and that the central pivot, the lone star immobile, was the pole star of the Northern Ladle. The Central Palace, associated with the direction of this Center and the element Earth, was the area of the sky which was always visible throughout the year. For an observer at the North Pole, the whole of the sky, i.e. celestial vault, is occupied by the Central palace, the whole sky rotating round the observer’s head throughout the year to which Earth obeyed by its direction/rotation.
In China, all philosophies, arts, and sciences stem from an ancient belief in man’s connection with the Cosmos (the Tao, God) which reveals itself in every phase of life. In Chinese cosmology, the universe is conceived of as a vast indivisible entity within the celestial vault. Within it, each single being has its definite function. No one thing can exist without the others, and to each thing, in turn, is linked a chain of concepts which correspond to each other in harmonious balance. To violate this harmony is to hurl chaos, wars and catastrophes upon all mankind, and sickness upon the individual. Man must therefore strive to adjust himself wholly within the world of those "correspondences," in which the five phases of earthly annual life correspond - Spring (wood), Summer (fire), End Summer (earth-central), Fall (metal), and Winter (water). Wu hsing, the five seasons of the year, constitute the guiding principles of all life’s manifestations. These are said to create one another, but also control (if not destroy) one another, depending on the sequence of manifestation.
We can see from these passages two important facets of Chinese culture: one, the significance of the skyward palaces from which the Emperor is responsible to take his cues; and secondly the direction from which order is to preserve his government. The Emperors were responsible to receive the mandates from heaven and apply those to his stations. In China this was termed interpretation of the Celestial Mandate through the ministration of Heaven’s markers. This knowledge was considered sacred and the Emperors concealed their calendars from the public. At some reigning periods, possession of a calendar by a common person led to corporeal punishment and even death.
The Chinese mentality of the time was radically different from development of Western-Greek culture. For example, by reason, heaven could not subsist on North and West alone, for North and West are Yin. The earth could not subsist on East and South alone, for East and South are Yang. The essences of Yang rise up to Heaven. Heaven is filled with light; on earth darkness and emptiness reigns. The essences of Yin sink down onto earth. Thus abundance rules below and emptiness above. From these perspectives, the same rules apply to the body. The upper part of the body is yang, the lower part is yin.
Overlooking or not knowing the symbolism of the five cardinal points has led to many misinterpretations now legion in acupuncture. For decades, translators called wu-hsing the ‘five elements’, equating it in essence to the Greek elements of earth, air, fire and water, rather than to phases of energetic and seasonal manifestations. The French in their spirit of perception called the Pericardium meridian circulation-sex, of which it is not now accepted by convention. Ren mo, often called “conception” vessel in many French and English texts, would refer only to a female’s anatomy, whereas the Chinese character oft cited actually means “to appoint” or “assume a post.,” implying social status or orderly conduct. Orderly conduct in the Chinese mentality of the times would mean complying with the forces of nature, the seasons, the elements, the activities, etc. as we have read.
Consequently the meridians must be conceived in true astronomical terms - i.e. meridians - lines of force (energy fields), demarcations of space/time, just as earth witnesses the orbits of the planets, the sun and moon defined by effects of gravitation, light, heat and mass reactions. From this paradigm, one can begin to truly understand the conceptions the ancient masters and terms that were used that seem perplexing on the surface yet convey deep meanings when understood. For example, our Tu mo (heaven-yang) and Ren mo (terrestrial-yin) meridians form a longitudinal loop, or celestial pivot, up and down the spine through the midline of the abdomen, chest and face; that circulates the energy of man/woman (ancestral energy). By orderly conduct (Ren) and direction from the heavens (Tu) comes longevity and free spirit, the essentials of Taoist principles, and shang yi, upper or higher medicine.
Traditional Chinese Medicine holds that there is a relative adaptation of the human body to the environment, and that the body’s ch’i flows according to cycles determined by the sun, moon, and stars. The methods of adopting stems and branches in the choice and timing of when to puncture has its origins in the Nei Ching and Nan Ching (Classic on Difficulties). These methods termed Zi Wu Liu Zhu, Ling Gui Ba Fa, Fei Teng Ba Fa, etc. are considered precious in China, and are used to select points on time, day by day. They have been tested by “numerous trials” of the past and provide therapeutic results superior to random selection of points by symptomatology or other recent rationale.
To achieve the skills necessary, the traditional acupuncturist must be intimately familiar with the Chinese calendar, the branch hours of the day, and know how to puncture following the seasons. The ancients held that the waxing and waning of vital energy and blood is closely associated with timing of the Stems and Branches and specific points opened and closed according to the timing of these celestial cycles.
Feng-shui, Wind and Water
Second, in the importance and generally not recognized as part of acupuncture philosophy is that of directionology. To the Chinese, the earth and the cosmos comprise one “living, breathing organism.” Just as the planets convey configurational forces in both Chinese and Western astrology, earth forces known as feng shui - wind and water - are considered to be responsible for not only human health, but also prosperity and good fortune. Feng shui also is a language of symbols. Qi (Ch’i) spirals in and around the earth, ever changing, sometimes “exhaling” and sometimes “inhaling,” always pulsating and manifesting itself in different ways and forms. When ch’i “brushes” the earth, it causes trees to form, grass to be green, air to be fresh, and water to be clear. Man is able to live comfortably and contentedly. When ch’i is too far away, or exhausted, no water flows, pollution and sickness thrive, and there will be bad luck and misfortune. When ch’i bottles or pents up, there are storms and natural disasters, e.g. volcanoes, earthquakes, tsunami waves, etc. Life in the Chinese conception is always flowing, always exchanging (yin yang), always transforming.
“How else than by ch’i can the sun, moon, and stars shine, can all beings rise (spring), mature (summer), bear fruit (fall), withdraw (winter) in course with the four seasons... The Shen of Heaven manifests itself as ch’i on Earth... The yin and the yang rise and fall by ch’i.”
Atmospheric ch’i molds and nourishes human ch’i. It must flow smoothly and allowed to permeate the person and his/her meridians. As with mountains and streams, the human body is also carried by ch’i, its central energy. The ch’i flowing out of our arms allows us to move, grasp, write, eat, etc. The ch’i flowing out of our legs allows us to walk, run, rest, etc. Human ch’i unites mind and flesh. It propels us through life, imparting gracefulness and serenity, or lack of brings misery and disease. Atmospheric ch’i shapes human ch’i, casting man’s destiny. Atmospheric ch’i also influences man’s health, catalyzing energy through respiration, or delivering sickness when perverse wind penetrates the skin. Acupuncture is forbidden during periods of “great cold, great heat, heavy storm, heavy rain.” These religious concepts are axiomatic to Chinese acupuncture.
Directionology has a very important influence on man’s surroundings, the flow or blockage of energy, often expressed as fortunate or unfortunate directions. Feng shui evolved into a refined art from the simple observation that people are often affected for good or ill by their surroundings - the position of their home, the direction into which the front door opened, the arrival of a bird during contemplation, the terrain in which a crop was planted. Every part of one’s surroundings or habitat and the ways in which they face wind and water have an effect upon the vital energy. The goal of Feng Shui is a crowning example of the of the difference of the fate and destiny bound up in Western astrology, versus the more humane Chinese astrology. Man and woman make their destiny and by changing your surroundings to be in harmony with the cosmos, you change your life for the better. The goal of Feng shui directionology is complete harmony with the natural order which, when achieved, will bring prosperity, health and happiness.
Directionology has a very important and tangible influence in many matters of life in Chinese mentality, from the consulting of an almanac to engage in a lucky direction for a meeting of the day, to the brick and mortars positioned by masons for buildings, and to the movements of the heads of state as quoted. The Chinese saw a mystical link between man, the heavens and landscape: nature reacts to any change and that reaction resounds in man. They viewed the world and themselves as part of a sacred metabolic system. Everything pulsed with life. Everything depended on everything else. From the Chinese perspective, man shares a fate with earth. When it was balanced it was healthy and prospered; when out of balance, the people, crops, and life suffer.
In Chapter nine of the Ling Shu, The Origin and the End we read:
“The art of acupuncture can be summed up in this axiom: It is the knowledge of the origin and of the end. An acupuncturist who is able to perceive the beginning and the end, the Yin and the Yang, the function of the five organs, can be considered as having attained perfection. The Yin rules the organs, the Yang the bowels. Yin absorbs the energy of Heaven, Yang absorbs the energy of the earth. This is why, when one disperses, one punctures in front of the circulation of the energy, whereas when one reinforces one follows the direction of the circulation of the energy. This fashion of puncturing allows one to regularize the energies.”
The ancient masters insisted upon the manner in which the needle was inserted, upon the method of manipulation during the puncture, and finally upon the manner in which it was withdrawn. This is in essence and in effect an application of feng shui. They recognized three distinct depths: the celestial level (t’ien pu); the level of man (jen pu); and the level of earth (t’u pu). The cornerstone of acupuncture itself, was the Great Law of Pu-Hsieh. Pu means to supply energy where it is lacking, hsieh means to calm or retire where ch’i is excess. These methods should not be confused with today’s modern terminology, to tonify or sedate. The terms of Pu and Hsueh-Hai have been in the vocabulary of acupuncture for many thousands of years. They imply that considerable care be exercised when puncturing with the needle as vital energy - ch’i - must not escape from the organism when the needle is withdrawn or the organism will be weakened. In this respect, the old texts were very precise: “When the energy arrives at the needle, it must not be withdrawn until the energy is calmed.”
The objective of acupuncture is to reach the ch’i current and there influence its flow. Reinforcing and calming means to follow or oppose the flow of ch’i. To reinforce, the needle is pointed in the direction of the flow of the meridians - “follow it, to help, is to reinforce.” To calm the energy, the needle is pointed against the flow of the meridians - “oppose it, to take, is to relieve.”
We can state adequately, many if not most of the ancient rules of acupuncture today are not followed. Many glamorous texts have been written yet when visiting the doctor’s clinic one is stymied to find the rules are broken or not even applied. Some authors even speak of them with disdain, as if having no application in modern practice. In the busy clinical practice, it all too often seems to matter not if it is raining or storming outside the air conditioned office, whether the patient is nervous or upset, whether the entrance points north, south, east or west, or even the post prandial condition of the obese patient.
We must ask ourselves, by the act of secularizing the healing arts, how far we have drifted away from our glorious past? What elements that have been effaced now render our skills less effective? May we find consolation in a weekend sitting, refreshing our faith by another reading of the Su Wen and Ling Shu?
Regarding The Huangdi Neijing
The first text, the Suwen (素問), also known as Basic Questions, covers the theoretical foundations of Chinese Medicine and its diagnostic methods. The are elucidated upon by the scholar contemporary, Dr. Manfred Porkert, in his eloquent text always handy for mental grooming, Theoretical Foundations of Chinese Medicine: Systems of Correspondence.
The second and generally less referred-to text, the Lingshu (靈樞) [Spiritual Pivot], discusses acupuncture therapy in great detail. Collectively, these two texts are known as the Neijing or Huangdi Neijing. In practice, however, the title Neijing often refers only to the more influential Suwen. Two other texts also carried the prefix Huangdi neijing in their titles: the Mingtang 明堂 ["Hall of Light"] and the Taisu 太素 ["Grand Basis"], both of which have survived only partially.
The third, which must be mentioned, the Nan-ching--The Classic of Difficult Issues, a fundamental book in the study of Traditional Chinese Medicine (TCM). Practitioners of Chinese medicine should always read and give homage to the two books of the Huang Ti Nei Ching, the Su Wen and the Ling Shu. The Nan Ching is a must for every Chinese Medicine practitioner also. This book gives many aspects that make one think again, and again, on theories and practical aspects that should be in use every day as practitioner of Chinese Acupuncture.
A lot of books of Chinese medicine from antiquity, as with the Bible, were translated, but often the translation is not correct or definitively wrong or even bizarre. In my early career dating back to the early 1970’s, I obtained a copy of Ilza Veith’s “New Edition,” The Yellow Emperor’s Classic of Internal Medicine (Chapters 1-34, 1949). We find in the translation of Chapter 22 a major mistranslation, as the taste ascribed to the liver as sweet, that of the heart as sour, of the spleen salty, the lungs bitter, and the kidney’s pungent. A perpetuation of this error would instill serious errors and prescriptions in dietetics and herbalism.
In 1973, Henry Lu of the Academy of Oriental Heritage introduced his translation of A Complete Translation of the Yellow Emperor's Classics of Internal Medicine and the Difficult Classics. Finally, the budding acupuncturist’s of our era had a fairly correct translation of the Su Wen and Ling Shu, but the English of difficult syntax.
Actually, the pivotal series of books on Acupuncture, yet to be equaled are the volumes 1-6 of the Les Livrs Sacres de Medicine Chinoise, by Docteur A. Chamfrault, Larureat de la Faculte de Medicine and M. Ung Kang Sam, Medecin-Specialiste de la Medecine Chinoise a Haiphong (Vietnam, 1973). Volume II is devoted to a scholarly and acupuncturally correct translation of the Su Wen and Ling Shu. The books are in French, and thanks to today’s software, have been made readable in English. The first volume on Acupuncture, Moxa and Massage, is a pivotal text, with the indications of the acupuncture points never to be equaled. The last volume, coauthored with Ngyuen Van Nghi, is the best and most detailed elucidation of the submeridians.
Effectively, these are the Bibles of acupuncture. And how often are they quoted, yet their precepts ignored?
May we pray?