Editor's note: The following article was written in response to "A Rediscovery of Classical Chinese Tone Therapy" by Dean Lloyd, RAc, HHP. Mr. Lloyd's article can be viewed at http://www.acupuncturetoday.com/archives2003/feb/02lloyd.html.
Examination of the classical Chinese medical and music theory literature leaves little doubt in my mind that ancient Chinese medical music therapy (which included tone therapy) and the development of music theory were intertwined. There is no doubt in my mind that the articulation of acupuncture theory incorporates elements of acoustical laws, music theory, and treatment references from the earliest use of music in therapy. The music therapy references evolved from the earliest use of single pure tones to subsequent use of all elements of music, including pitch, key (pentatonic mode), tempo, volume, timbre (unique to instrumentation), musical style and time (hour, month, season) of intervention.
References in the system of correspondences, which seem to have piqued the curiosity of some people enough to explore clinically, are those made to key or pitch associated with each of the five phases. I agree with Mr. Lloyd's assertion that the research on tones (pitch) in treatment cannot be ignored. I was dismayed, however, by Mr. Lloyd's assertion that "the work in discovering these tones has been completed ..." I hope that the contemporary work has just begun.
I also have explored the subject. With the assistance of seven experienced, Worsley-trained acupuncturists, we clinically tested the interaction of musical pure tone and meridian energy. As a musician and instrumentalist, I was keenly aware that music sometimes affected pulse changes in sensations in people the same way needling in acupuncture did. My formal exploration began as a master's degree candidate in holistic therapeutic process at Lesley College. My interest in determining the tones - and by extension, key - associated with the yin aspect each of the five elemental phases was to refine musical selection with more predictable therapeutic utility in my music and guided imagery psychotherapy practice. After extensive examination of both primary and secondary acupuncture theory resources, as well as music history and theory resource materials, I reached a tentative conclusion about how those pitches should best be determined, what those pitches might be, and how they should be produced for clinical testing (Living Images, Music and Other Cycles, 1985).
Pure tone harmonics (one-wave frequency) are naturally generated in a particular temporal sequence from a fundamental (multiple wave frequencies) sounded on any musical instrument - including the human voice. Some of the pure tones are audible; some are not. However, all of the tones necessary to create what we know as a musical scale are contained within this harmonic series. These tones demonstrate acoustical laws. Observation of the auditory and mathematical patterns in this natural phenomenon contained prerequisite knowledge for the subsequent codification of acoustical laws, the development of music theory and, eventually, the development of numerous pentatonic modes characteristic of early Chinese music. The more refined music theory and practice became, the more complex musical references in the system of correspondences became. In the later literature, it is difficult to separate those references in the system that are an explication of music theory, from those that are prescriptions for music therapy interventions.
The earliest literature suggested to me that the original tones associated with only the yin aspect of each phase were the harmonic (pure) tones naturally generated in a temporal sequence from a specific fundamental. Hypothesizing that the human voice was probably the first generator of tones used in sound therapy, I chose pure tones generated from a fundamental sounded at the threshold of human auditory perception and at the lower limit of the human singing voice - C2. Other mathematical references relative to music theory, production of musical instruments, and calendar development have supported this hypothesis.
The literature also suggested to me that the numbers associated with each elemental phase completion were substantively the same as the ordinal numbers representing those harmonics. I matched the ordinal number and pitches of the harmonic overtones (pure tones) with the elemental completion numbers. Arranging these pitches in chromatic order (scale-like) resulted in one of the first developed pentatonic modes (kong mode) as well as the k'o cycle sequence prescribed in the literature as essential for therapeutic sound wave intervention. The tones were the 4th and 8th harmonic pure tone, C = Wood; the 5th harmonic pure tone, E = Earth; the 6th harmonic pure tone, G = Water; the 7th harmonic pure tone, A = Fire; and the 9th harmonic pure tone, D = Metal. Had I chosen a different fundamental, the specific pitches would have been different; the intervallic relationships between them, the ordinal numbers and the phase number correspondence would have remained constant.
From this hypothetical assignment of pitch and key, I developed a set of guidelines for selecting music based on key, as well as the other guidelines one normally employs when using music in therapy (Living Images). Because of the difficulty of holding variables constant in music therapy research - even through statistical analysis - these musical interventions have not been clinically tested with the same rigor as was subsequent work.
I began my doctoral work at the University of Massachusetts in 1987 with the intention of testing my theory and each of the five pitches assigned to only the yin meridians. Since the tones assigned to each phase were harmonic, the most easily accessible, least expensive and most reliable instrument that could generate these pure tones in a clinical setting were tuning forks. In the process of enlisting experienced acupuncture practitioners who would test the tones, I heard of Fabian Maman's work.
My interpretation of schematics obtained from Mr. Maman's unpublished work (1987) revealed that he had assigned a pitch to each command point on both yin and yang meridians by modulating in musical 5ths through each meridian. This effectively assigned a different pentatonic mode to each meridian with the key not of that mode assigned to the element-within-the-element point. If I had utilized Fabian Maman's system, different pitches would have been assigned for use on the points I intended to use (Earth only) in my experimental testing. I knew that Maman's theoretical frame for pitch assignment was created centuries later in the development of music theory than was my theoretical frame. While musically coherent and probably historically accurate, I did not know how effective his pitch assignments were. I did not know if those pitch assignments would be more or less effective than the ones I had selected.
A summary of my pilot study results follows:
Forty-three acupuncture patients were treated with musical sound wave (E 329.6 Hz) on Earth points of major yin meridians when those points were clinically indicated. The pure-tone sound wave was generated with a tuning fork, and each patient was tested and retested within 72 days for matched-pair analysis of data. Three response categories - better, no change and worse - were compared with attention given to quantitative and qualitative differences as a function of age, CF, point, point function, meridian, and the season in which the treatments were received. Statistically significant results (p = .05) indicated that treatment responses were not individually specific. Statistically significant results also indicated that therapeutic responses were more reliably accomplished on tonification points (IV3, IX9) and on XII3 than they were on I7, V7, VIII3. Analysis suggests that effectiveness of this pitch may be meridian-specific and point-specific. Trends in the data suggest that therapeutic responsivity was CF-specific, with people having Water CFs showing more therapeutic response to treatment than people with other CFs. Trends suggest that therapeutic response was possibly season-specific, with late summer therapeutic responses somewhat greater than those from treatments received in other seasons. Trends in the data support the hypothesis that overtone frequency (E 329.6 Hz) is the equivalent to kong (the sound associated with Earth) if the fundamental is C2.
Equally is important as this evidence, patients and practitioners had very positive comments about the subjective experience - each from his or her own perspective - when the treatments were therapeutic. Practitioners reported "bigger" and "clearer" pulse changes than those expected from needling. Patients reported vivid imagery and sensations that were "gentler" and "less overwhelming" than when needled. Comments equally as negative were made by both patients and practitioners when the treatment outcome was "worse." All nontherapeutic changes could be rectified with subsequent needling.
The only "problem" practitioners reported in administering the sound wave was remembering to use the tuning fork when an opportunity within the scope of the experimental design presented itself. Through a process of practitioner attrition from the study and a looming statute of limitations for completion of the study, it was terminated with experimental data available from only one of the five tones. Statistical data from this study would have been more conclusive had there been more trials from the one tone tested. Unfortunately, some of the experimental trials were eliminated from the statistical analysis because of missing information or because no treatments occurred within the 72 days for the matched-pair requirement. Study results would have been even more conclusive if at least one more tone had been tested.
Looking at these results in light of both Maman's and Dean Lloyd's work - despite the use of different tones on the same points - therapeutic results do occur when acupuncture points are treated with sound waves. The frequency rate of these therapeutic results and the quality of experience warrant further research. I think it is possible to identify the frequencies which are most therapeutically reliable. It is my hope that there are other people out there willing to continue the research so that treatment outcome with pure-tone wave frequencies can be measured conclusively.
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