Chronic Degenerative Disease and the Divergent Channels

Acupuncture channels are living entities. Through them we can observe and experience the laws of nature. The Nei Jing reminds us the human body has holographic resonance with the natural world. The acupuncture channels are "codes" teaching us natural physiological process: how nature occurs in the body. They also discuss pathological reaction to the internal and external environments.

Chapter 11 of the Ling Shu advises: "for a beginner treating disease he must learn the theory of the channel, and for a good physician he must also take good attention to it. A physician of lower level thinks the theory of the channel is easy to learn, but a physician of higher level deems that the study of it can hardly be proficient...the condition of the channel is what the imprudent physician neglects and what an astute physician studies carefully." Deep understanding of the acupuncture channels is essential for the Chinese medical healer. As one continually studies them, the depth of the channels reveal themselves. They represent human existence. Like life, they are mysterious. Magical. A mixture of scientific order and celestial mystery. Heaven and Earth played out through humanity. They are inexhaustible in their wisdom. Great teachers. They command respect; reverence, developed slowly over time as we build relationship with them.

The Divergent Channels are described in Chapter 11 of the Ling Shu. These channels are often seen as the most mysterious. They are introduced as "corresponding to the phenomenon of the natural world." The theme of this chapter states "the human body agrees with the natural world." The Divergents are channels that measure how harmonized we are with nature within and without. The channel descriptions that follow describe "separations" from the Primary Channels, traveling to areas of latency: the bony cavities of the body.

Chapter 11 seems to be a simple chapter discussing channel trajectories. As with many chapters in the Nei Jing, and Taoist literature in general, the information is "coded." Deeper meaning is unlocked when metaphorical significance of the images are understood. To understand Chapter 11, one must understand the Divergent Channels. To understand the Divergent Channels, one must appreciate the mysterious theme in which they are introduced.

Numerous philosophical statements are presented through description of acupuncture channels. What may seem like a simple anatomical map is really a detailed medical treatise. Within each channel are philosophical implications, physiological and pathological theories and treatment strategies.

For example, the first part of the Bladder Divergent Channel begins at the back of the knee at the point Bladder 40. It travels into the gluteus to Bladder 36, into the anus/tailbone at Governor Vessel 1, wraps the pelvis to meet Conception Vessel 3 and 4 before traveling again to the lumbar at Governor Vessel 4. There is a world of information in this simple map. Information about the role of the channel, it's pathological development, as well as strategies for healing and "spiritual" cultivation.

The acupuncture channels, especially those presented in the Nei Jing are keys to understanding human life, health and disease. To "mine" these wells of knowledge, one must inquire into the meaning of the channel. Understanding the role, actions and philosophy of each channel, both within its own channel system and amongst all the channel systems, becomes vital.

Further information about Divergent Channels is found in Chapter 63 of the Su Wen. This is a chapter about disease progression, described as movement through the acupuncture channels. Pathogens move from the layer of the skin (the cutaneous channels) into the "minute collaterals" (sinew channels and luo vessels).

A "collateral" is a vessel used to block movement of pathogen into the (primary) "channel." The collaterals are modernly referred to as "secondary vessels." They are safeguards for the Primary Channels. Pathogens can potentially disrupt physiological function when they attack the Primary Channel. They can also find passage into the Zang Fu, threatening organ function. Collaterals translocate pathogens away from primary circulation, keeping them trapped in common areas of latency like the minor blood vessels.

When the "minute" collaterals fail to hold, explains Chapter 63, the pathogen will be released into the Primary Channel, eventually injuring the Zang Fu.

The body has a second line of defense after the "minute collaterals" have failed. The pathogen "will flow into the Large Collateral and...evil energy runs in all directions, not staying in a proper place." Symptoms will manifest, yet the pathogen is safeguarded from flowing into the Primary Channel and Zang Fu. The modern name for this process is "the disease nemesis theory." The body understands its priority is to stay alive. Pathogenic invasion into the Zang Fu can be life threatening. If the body could get rid of the pathogen, it would. But since it can't, it compromises and stuffs the pathogen into an energetic closet, where it will create symptoms, yet not threaten life. Most degenerative diseases are examples of this. Pain from inflammation and tissue destruction result, but the organs remain safe, and life continues.

The "minute" and "large" collaterals are similar in that they both translocate pathogens alway from the Primary Channels. They both manifest symptomatically as Bi obstruction, rebellious qi and Shen disturbances. The differences are where latency is held. The Luo Vessels hold latency in the minor blood vessels of the body; the Divergent Channels do so through the joints. One utilizes blood, the other uses Jing.

Modernly, the Divergent Channels are taught as essential in treatment of chronic degenerative diseases. They are challenging to work with and understand. They directly confront the process of aging and degeneration; facing the mystery of human life and death. They are existential channels. Being collaterals, the Divergent Channels are not associated with physiology. They are pathological channels, essentially "buying us time" as unresolved accumulations consume us.

Chronic degenerative disease is the top health concern in the modern developed world. According to the Center for Disease Control, "7 out of 10 deaths among Americans are due to chronic illness. More than 133 million Americans have at least one chronic illness. Heart disease, cancer and stroke account for 50 percent of all deaths each year; arthritis is the most common cause of disability, and diabetes is the leading cause of kidney failure and blindness."

The degenerative process has been a focus throughout the centuries. Chapter 1 of the Su Wen begins with a discussion as to why some people live long healthy lives and others decline rapidly, dying at an early age. This sets the tone of the Nei Jing as a book teaching us about longevity practices.

Commentaries on the channel systems have said the Divergent Channels are the first acupuncture channels a clinician should study. Perhaps because the degenerative process is the most challenging aspect about human life. Degeneration is natural. Life is cyclical: all things come to an end. We age and eventually die. However, the Nei Jing teaches us that the cycle of birth, growth and death can be extended or shortened: it is based on many factors. Much that modern medicine attributes to "aging," can be argued as more complicated. The acupuncture channels, especially the "collaterals" describe the process of rapid degeneration, and ways to prevent it.

In Chinese Medical theory, there are three major causes of disease: pathogens from the external environment, internal disharmony caused by diet and emotions, and lifestyle factors.

Aging, diet and lifestyle factors are also acknowledged by Western medicine as leading contributors to degenerative disease. Chinese Medicine also details how externally contracted agents (wind, cold, dampness), as well as emotional disturbance are additional contributors to the chronic degenerative process.

The Su Wen discusses relationship between pain (Bi obstruction syndrome) and the inflammatory process that leads to physical degeneration (Wei Atrophy Syndrome). Chapters 33 and 34 discuss the progression of wind-damp-cold penetration into the body's sinews. "If the Bi-disease has entered into the viscera, the patient will die; if it lingers in the tendon and bone, the pain will be protracted; if it retains in the skin only, the patient can be recovered more easily." Movement of pathogen into the Zang is lethal, therefore the body will do all it can to translocate it elsewhere. The collaterals are places where pathogens are stored to safeguard the Zang organs. The Sinew Channels keep pathogens in the level of the skin and muscles, the Luo Vessels in the level of the blood vessels, and the Divergent Channels in the bones and joints. Chapter 43 states that Bi doesn't always cause pain. Pain can be intermittent or non-existent based on where and how it is being held.

Chapter 44 describes the progression of Bi into flaccidity, numbness and loss of limbic function: essentially degeneration.

Many chronic degenerative conditions involve the tissues of the body: the muscles and bones/joints. They also involve tissues involved with blood flow: the heart, spleen (manifesting in the flesh), and liver (blood pressure). Divergent Channel acupuncture points are modernly seen as a primitive rendering of the lymph system: another area associated with degenerative processes. Theories of the collateral systems describe how and why tissue degeneration occurs.

Many see chronic degenerative processes as a blessing in disguise. Chapter 63 of the Su Wen introduces this possibility. If a pathogen reaches the Zang, the person can die. When it is trapped in the collaterals, there will be pain and symptomology, but death is not eminent. Quality of life is affected, but life itself continues.

The Divergent Channels are a progression theory. They describe how pathogens trapped in the "Large Collaterals" are kept under control by the humors of the body, beginning with the densest (Jing and blood) to the thiner (Jin Ye) to the most immaterial (qi and yang). Any pathogen kept latent in the body will create heat, which will ultimately consume the humor keeping it trapped. As each humor is consumed, the next densest material will come to support the latency. Blood supports Jing; fluids support blood; qi supports fluids; yang is the root of everything.

The Divergent Channel progression begins with the Bladder and Kidney, representing the humor of Jing: the densest material in the body, and the first substance used to maintain latency. The Gallbladder and Liver Divergent Channel pair follows, representing blood supporting latency. Stomach/Spleen and Small Intestine/Heart represent Jin and Ye fluids, respectively. Triple Heater/Pericardium represent qi as it tries to consolidate for latency. The final stage in the Divergent Channel continuum is Large Intestine/Lung, which represents the basic yang qi of the body: the root of all functionality.

Chapter 11 of the Ling Shu describes latency trapped in the Jing, progressing into eventual collapse of yang qi: organ failure. At the level of Triple Heater, the yin humors of the body have been consumed, marking the body's "loss of latency." This is the stage when the dormant condition begins to emerge and spread throughout the body. The body tries desperately to find any available yin substance to re-establish latency. It does this through consolidation of post-natal qi. If it fails, the body will move into the final stage of the Large Intestine and Lung where the pathogen gets released back into the Primary Channels. This stage differs from that described in Chapter 63 of the Su Wen. When the pathogen was originally released from the "minute collateral" (Luo Vessel) back into the Primary Channel, there was still sufficient Jing (yin and yang) to move it into a deeper collateral. However at the point of the Large Intestine and Lung Divergent Channel stage, all the resources of the body have been exhausted: the root has been damaged to the point that latency is no longer possible. There is now no longer a buffer between the pathogen and the Zang. The condition is now life-threatening.

The trajectories of the Divergent Channels presented in Chapter 11 of the Ling Shu not only teach disease progression, they also provide treatment strategies. The Divergent Channel trajectories are "odes" detailing actions required to resolve progressive degenerative conditions manifesting from a latent condition.

In all channel theory, there are medical strategies as well as philosophical implications. Illness is more than a physical occurrence. As humans we look for meaning in our lives. According to Classical Chinese Medicine we are born with a destiny, a curriculum, a path. Our heart has an agenda it wishes to explore; themes and desires that animate and cause it pain. It can be helpful, sometimes even necessary, to gain appreciation of these subtleties when trying to resolve a disease state.

The Divergent Channels are collaterals. They are conduits of yuan and wei qi, making connection between the deepest and most superficial layers of the body. Collaterals can be seen as "distractions" to the Primary Channels: they divert issues away from primary circulation. The Divergent Channels, as collaterals, divert issues into a very deep layer of the body, where they go into hiding. This is often referred to as "hidden qi" or latency. It can be likened to a very deep level of denial or repression. The Primary Channel could not deal with the issue, nor could the Luo Vessels. So the issue was finally stuffed into the joints: encased in Jing where it is stored away as long as possible.

There is a Shen component to the Divergent Channels. They are a type of "Luo Vessel," translocating unresolved issues into latency. As Luo Vessels, they manifest symptoms of Bi obstruction, rebellious qi and Shen disturbance. The Divergent Channels conduct energy that is deeper than the Luo Vessels. Divergent Channels penetrate into the yuan level: affecting one's "Xing" or nature. Personality changes are associated with the Divergent Channels: disturbance to the Triple Heater's irrigation of essential qi into the Zang organs.

Chapter 11 of the Ling Shu infers that issues associated with the Divergent Channels come about when we've become out of synch with nature. As humans we are part of nature. We must harmonize with the external environment. We also have an internal nature. At birth, the interaction between our Jing-Shen gives us a personality: a "Xing." The agenda of the Shen and Jing meet and empower the Triple Heater to allocate essential qi to the Zang organs accordingly. If we are destined to explore a "Wood Element" theme in life, the essential qi will favor the Liver Bladder Shu point, distributing more yuan qi into the Wood Element. Our personality will become Wood. We will see the world through a Wood point of view. Metal and Earth will either balance or challenge us; we will feel nourished and supported by Water, and supportive of Fire.

If we become traumatized during our lives, our "xing" can become damaged, causing alternation in our personality. This is equivalent to damage to the yuan level. The Triple Heater alters it's flow. Metaphorically we diverge onto a side path away from that which has been destined. Our life and it's actions begin to manifest through the collaterals instead of the primary channel.

Luo Vessels come about from placing too much or too little energy/attention on a particular aspect of our lives. Luo Vessels conduct blood. Blood is the vechicle of the Shen. The philosophical statement made through the Luo Vessels implies our mental-emotional focus has become fixated on a certain aspect of life. We keep obsessing on it, or continually playing it out. We bleed ourselves to death through our Luo Vessel fixations. Or if the vessel is empty, there may be avoidance of the issue. The Divergent Channels are more extreme than the Luo: they divert essence into these fixations, going so far as to alter our path in life, change our personality, or cause us to deny who we essentially are.

The Divergent Channels are ways to restore awareness. They are links to the yuan level: pathways to rediscover our destiny and true personalities. Once we have restored consciousness, we can begin to make different choices that better support our being. This is a requirement in healing. First: awareness as to how our lifestyles, environments, thinking or emotional lives have been contributing to our illness. Then: change that which is inconsistent with our health and wellbeing. Healing requires letting go: of the past, our delusions, our unfinished and unfulfilled desires.

The Divergent Channels are confronting. They put us in touch with who we really are. Some of us have tremendous fear about who we are. Some of us hate who we are. They bring up repressions: how we run away from ourselves. They also ask us to acknowledge ways we attack ourselves: our autoimmune tendencies. In a way, they have a strong resonance with the Qiao Vessels: the ability to find peace within ourselves, and peace within our environment. They also resonate with Jing Well points: the ability to awaken consciousness, ideally to let go and move on.

The philosophical implications of a channel system are discovered through many aspects. Where they appear in the continuum, how the trajectories flow, the type of qi they conduct, associated symptomology.

Divergent Channels conduct wei qi: how we acclimate with our environment. Are we in resistance: to the world and our true natures? Wei qi as it connects with yuan qi creates expression of our essential qi through unconscious behavior. Divergent Channel manifestations of Bi obstruction, rebellious qi and Shen disturbance go quite a bit further than physical symptoms. They represent ways we deal with our lives and ourselves: how we behave, often unconsciously - through posture and attitudes.

The Divergents can be channels of deliverance; cultivation of greater authenticity. This is why they are confronting. However, such confrontation is sometimes the only "way out" of a diseased state. According to Taoist philosophy, we can run from our destiny, but we cannot hide from it. Eventually our true self and it's unfinished business will find us. If not in this life, then in the next. Using the words of Buddhist teacher Pema Chodron, the Divergent Channels provide "wisdom of no escape."

References:

• Chodron, Pema. The Wisdom of No Escape. Shambhala, Boston, MA 1991.
• Liansheng, Wu; Qi Wu (translators). Yellow Emperor's Cannon of Internal Medicine (Nei Jing). China Science & Technology Press.
• Yuen, Jeffrey. Lecture on Jing Bie/Divergent Channels: The Humors and Their Relationship to Zang-Fu, June 19 - 20, 2010 at Chinatown Wellness Center, NY,NY.
• Yuen, Jeffrey. Lecture on Jing Bie/Divergent Channels and Their Treatment Strategies, October 9 - 10, 2010 at Chinatown Wellness Center, NY,NY.
• Yuen, Jeffrey. Lecture on Chinese Herbal Strategies for Musculoskeletal Disorders (Wai Ke), March 17-18 at the Chinatown Wellness Center, NY,NY.
• www.cdc.gov/chronicdisease/overview/index.htm