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Secondary Channels of Acupuncture

By Nicholas Sieben, LAc

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Constructing Our Reality, Part 2

My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel. The bladder is a major crossroads within the primary channel sequence as presented in chapter 10 of the Ling Shu.

Sun Si Miao emphasizes the importance of the bladder channel in treating sensory disturbances. In his Formulas Worth a Thousand Ducats, Miao says the point BL-23 is very important when there is "head wind" accompanied by disturbance in sensory function. The point BL-23 builds back yang qi for sensory health and function. Miao also suggests that whenever the sensory organs are affected by "head wind," this indicates shao yang has become affected.

In terms of classic Shang Han Lun theory, all external conditions begin at the level of tai yang, which in acupuncture language relates to the bladder and small intestine channels. Tai yang is what interfaces with the external environment. The bladder channel, through its relationship with the kidneys, is what provides yang qi that goes to the surface of the body. When the tai yang level of the body weakens, disease transmission can occur. Disease can mutate as it moves into different channels and zones in the body. Transmission is based on the body's strength and available resources. If the fluid system of the body is weak, tai yang will likely transmit into yang ming to cause an inflammatory situation. Whereas, if the yang qi of the body is weak, tai yang is likely to transmit into shao yang.

Chapter five of the Ling Shu, "Roots and Terminations," validates Miao's theory. Chapter five suggests pathology that remains unresolved within the external wei level of the body will accumulate and become trapped within the sensory organs of the head.

Energetically, shao yang represents a "pivot" or "axis." It is a disease stage where pathology becomes trapped half way between the exterior and interior layers of the body. The body remains strong enough to resist pathological penetration into the interior, yet lacks the full strength to fully expel or release the issue. Psychologically, this resembles a state of confusion: not knowing what to do. It becomes clear why gallbladder- a shao yang channel- has come to be associated with decision-making. When the senses become blocked, it can be extremely difficult to perceive what we should do.

The point BL-23 is indicated by Miao as a place where the yang qi of the body can be strengthened to deal with the vulnerability of shao yang. It therefore becomes a very important point for resolving conditions affecting the sensory organs. Miao helps remind us that it's important to explore the importance of the bladder channel in our discussion of sensory perception.

The concept of "head wind" is interesting. The term "wind" is used in Chinese medicine to designate any challenge coming from the external world - virus, bacteria, fungus, pestilence or parasite - this is all considered wind. Philosophically, wind is also a metaphor for change. Head wind can occur when the body is confronted with an external pathogen; it can also occur when we are being asked to adjust to changing circumstances occurring around us.

Philosophically, the level of yang ming, associated with the condition "wind-heat" is a manifestation of wanting circumstances to change quickly and impatiently. Heat is generated when the physiological wei qi of the body (a subcategory of yang qi) becomes stagnated by external cold. Cold is strong; it makes us slow down or stop. It demands attention. Wind (change) carries the cold into the body. The cold forces us to deal with the challenge. Most of us don't like having our lives interrupted, so we resist the cold, which creates heat. Rather than gather our full attention and become fully present with the challenge at hand, we resist and fight. We just want to get past the challenge. But we don't really attend to it with our full presence.

Tai yang is what grapples with cold. It requires a tremendous surge of yang qi to create full resolution to a challenge brought by "wind cold." The chief function of the bladder primary channel is to consolidate the yang qi of the body so we can be fully present in resolving challenges brought to us by the external world. The bladder takes anything that's lingering and brings it to a full state of cathartic resolution.

Tai yang is the part of ourselves that knows what to do and does it immediately, without thinking. The bladder interestingly is the only primary channel that doesn't travel through the diaphragm. It is not interested in influences of the post-natal world. It will not debate. It is like the devoted servant of the kidneys, which controls the original qi of the body. This is how the bladder is able to be cathartic and complete in its relationship with the exterior world. It doesn't fight with the problem by bringing it inside the body and allowing it to communicate with the shen (via the blood) as yang ming does. It doesn't take it "to heart." And it doesn't fall into a state of indecision or confusion as with shao yang. Tai yang calls on the wisdom of the kidneys to instinctively know what action to take. It's connection to the kidneys provides access to the power to do it.

This is the bladder aspect of tai yang. However, the Ling Shu suggests if the leg channels cannot resolve an issue, it will also affect the arm channel. The small intestine represents an issue that the body is not able to release or expel. The small intestine primary channel is where an overwhelming pathogen moves into a state of latency. Rather than just keeping the problem trapped in the senses, it gets absorbed into the bones where it is held in a lurking, yet relatively quiet state. Tai yang has a strong relationship with the divergent channels. The bladder divergent is the first channel in the sequence presented in chapter 11 of the Ling Shu. The bladder and small intestine primary channels contain themes related to the divergent channels, relating to the creation and release of latency.

The order a channel system is organized is important. The small intestine primary channel must come before the bladder. It represents the creation of latency. Bladder contains the capacity to let it go. If latency is not released, it will damage the essence at the level of the kidney - the next stage in the primary channel continuum.

Perhaps more than any other channels, the tai yang primary channels are best understood through exploration of the collateral systems of the body. The divergent channels resonate with similar themes as the bladder and small intestine primary channels.

We can also discover a lot about the primary channels through studying their luo vessels. It is interesting to note that chapter 10 of the Ling Shu discusses the primary channels, their trajectories and classical symptoms alongside the luo vessels. The luo act as holding vessels, which absorb unresolved pathology from the primary channels. They can also be seen as manifestations of primary channel function that have gone awry, especially in relation to the shen.

Longtime Jeffrey Yuen student Ann Cecil-Sterman, says in her book Advanced Acupuncture, that the bladder's luo vessel relates to the "feedback system" of the body. Leon Hammer says in his book Dragon Rises, Red Bird Flies that the tai yang aspect of the body can be likened to the nervous system.

The luo vessels of the body are what absorb the excesses of the primary channels. They act like ditches - a concept presented in the Nan Jing in its discussion of the extraordinary vessels. However, most of the collateral systems of the body, or so-called "secondary" acupuncture channel systems act as ditches for the primary channels. The luo absorb the stresses of the primary channel, putting it into a latent state on the surface of the body, within the circulatory system. These can be seen most commonly as varicosity on the surface of the skin.

The small intestine's luo vessel manifests as irregularities in defecation and small wart-like growths on the skin. Jeffrey Yuen teaches that these are the physical expressions of a state of neediness in which constant feedback is desired. This is a "fullness" in the small intestine's luo. When the luo empties, this leads to weakness of the elbow and uncertainty.

The bladder luo when "full," manifests in symptoms of nasal congestion, allergies, headaches and lower back pain. These are physical accompaniments to the panic or extreme anxiety that relates to an "alarm system" that is constantly on high alert. The feedback system of the body becomes overwhelmed. The person becomes highly reactive. When the bladder luo "empties," it can lead to nosebleeds - a manifestation of "heat in the blood" which can express itself as "fetishes" - lacking the awareness of when "enough is enough."

Both tai yang luo vessels relate to the feedback system of the body. Tai yang can become overstimulated, leading to problems within its luo. It is interesting to note that the lung's luo vessel symptom of "fullness" is interpreted as desire for constant stimulation. While the bladder's "fullness" is a feedback system that has become too overstimulated leading eventually to a breakdown of the system altogether. The person loses a sense of when to stop. They will tend to engage in activity beyond the healthy threshold of the body's capacity.

The small intestine's luo vessel suggests a lack of internal faith in one's own self-validation capacity. In response, it will look for validation outside the self. Whereas, the bladder's luo when "full" becomes too sensitive in its feedback capacity, seeing everything as a fight. The person loses natural discernment as to when its necessary to exercise the strong resolution energy of tai yang.

The sense organs have a dual function. They are "portals" fed by two different types of internal fluids. The thin "Jin" fluids have a wei-level function: they moisten the sense orifices to be able to release pathogens, giving them an excretory capacity. The thick "Ye" fluids connect the sense orifices to the internal organs as their antennae. The Jia Yu Jing says it's the small intestine that controls the Ye fluids. This further explains the "feedback system" associated with tai yang.

There appears to be a relationship between the natural occurring tai yang function of action-resolution and the fluids that nourish the sense orifices. Luo vessel theory suggests "feedback" becomes distorted within the luo of tai yang. Chapter 5 of the Ling Shu suggests this occurs due to unresolved pathology that collects around the sense orifices. Miao suggests that when the sense orifices become affected, this means shao yang (decision-making) has been affected.

The bladder primary channel adds another explanation to the sense orifices and the fluids. The Su Wen says that wind pathology follows a progression. If first affects the skin, then the head and sense orifices before moving into the bowels and finally into the viscera. Wind finds its way into the organs via the bladder shu points. The Nan Jing discusses conditions known as "Resistance" and "Closure." Part of this discussion focuses on blockage between the interior and exterior layers of the body, placing special emphasis on the sense orifices. It is likely that the classical symptoms associated with the bladder and small intestine luo vessels are part of this discussion. When a person's "portals" become blocked, either from their external wei-level manifestation (the Jin) or from their internal root in the organs, a person will lose capacity to discern what is harmful to their constitutional nature. This can lead a person, in the case of "emptiness" of the bladder's luo to engage in activities that are destructive to the constitution. This can include exhausting oneself to the point of essence deficiency, unaware that they have passed their own threshold of self-preservation.

The point BL-23 is important in two ways. First, as Miao suggests, it brings yang qi into the sense orifices to penetrate through blockages. However, BL-23 is also a point along the original dai vessel, which the Nan Jing says acts as a belt, holding together the integrity of the first ancestry of the extraordinary vessels: the Ren, Du and Chong: the Yin and Yang of the body. The bladder primary channel teaches us that in order to treat pathology that has progressed into the level of the constitution, it is necessary to consolidate the body's resources. This is also the way the body can restore functionality to the organs when they have become weakened by the penetration of wind via the bladder shu points.

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