Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
Dealing With Change: Resistance, Acceptance and Forgiveness
The essence of life is change: a continual taking in and letting go. This is the cyclical flow of nature. According to the Buddhists, change is an aspect of life with potential to cause tremendous pain. There's the "seed of suffering" in all things, teaches Buddhism. We suffer when something unpleasant happens to us. We also suffer when something pleasant happens, for eventually that something will end and go away. All things are temporary. Our life is temporary. We try to hold onto what is pleasant, and fear meeting with the unpleasant. We fail to realize both are temporary.
There's a lifespan to everything. In order for life to continue, things must die: things must change. Summer ends and winter comes. Every year this occurs. We live, and then we die. This is nature. We as human beings often feel great anxiety and vulnerability, as we never really know when things will change. Sometimes we are prepared; often we are not.
Our ability to "course the wind" and "go with the flow" is often directly related to our health. Wellness is predicated on adaptability - our ability to move with the wind. It's often our sentiments that get in the way; that which we hold in our hearts: our greatest hopes, our dreams, our plans. Our heart places its energy into examining a "palace" (agenda or theme), our liver creates a plan, our spleen the context, our stomach builds the structure. And, perhaps, like hurricane Sandy, a great wind and flood comes and takes it all away, when we least expect it.
The Lung is designated as the first channel of both the Primary Channels and the Luo Vessels. The Sinew and Divergent Channels both begin with the Bladder. The Extraordinary Vessels begin with the Sea of Blood (Chong Mai). What sort of statement are the ancients trying to make putting these channels first in the progression of their respective channel systems?
The Shang Han Lun school was the first to teach the theory of disease progression. When the body is confronted with a pathogen, the Tai Yang channel mobilizes its qi to "release" the exterior - letting go of whatever the problem may be. If Tai Yang can manage this, there is no progression: the problem is solved. However, if Tai Yang fails, there is movement into other channels (stages): the problem remains and the body fights, creating ever greater reaction until eventually the system becomes weakened from the effort. If reactions fail, the body will slowly give up, allowing itself to become consumed and drained of qi and blood.
Chong Mai is seen as the "blueprint." It provides the resources for all life: the yin (structure) via Ren Mai and the yang (capability) via Du Mai: both of which emerge from the Chong. The Chong also gives birth to the Qiao Vessels, allowing our "stance" towards ourselves and the world. Chong empowers the Wei Vessels: "the cycles of 7 and 8" that lead us through our lives; as well as the Dai Mai which wraps around the belt, keeping it all in place.
The Nei Jing says the Kidney "controls the exterior." The Bladder channel (the yang aspect of the Kidneys) is the initial interface with the exterior within the Sinew and Divergent Channels: two channel systems that conduct wei qi. Wei "immune energy" originates from the yang of the Kidneys, as yuan qi is the source of wei qi. Placing the Bladder as the initial channel in the sequence is an acknowledgment of this.
The Primary Channels and Luo Vessels both conduct ying qi. Wei qi is unconscious autonomic energy. Yuan qi is constitutional energy: also unconscious, yet possessing a deep wisdom and inner knowing. Ying qi has consciousness: it is blood, the medium ship which circulates the Shen.
Life is about more than physical function. We as human beings have more to us than instinctual need to survive and protect ourselves from danger. We also have a need to learn and cultivate awareness.
Life is about survival; it also about creating meaning. The Primary Channels, in commentary, are often associated with the Confucian virtues. To the Confucians, the purpose of life is creation of virtue. We learn to be "realized beings" through transforming our emotions into virtue through the process of learning, community involvement and service.
The Primary Channels begin with the Lungs as a representation of the essence of life: the breath. It is the breath that combusts the Kidney Jing, allowing yang qi to support wei qi. It is heaven that allows conception: the Lung qi that moves the menstrual blood. Heaven allows the Shen to meet with the Jing and create life. According to Primary Channel commentators, the Lungs allow communication between the Kidneys and the Heart. This is referred to as the "Yi Guan" - the one-link.
As with Tai Yang, the Lungs are the first interface with the exterior. If the body is able to let go and move on, the problem is eliminated: there is no need for progression. According to the Buddhists, though, this is easier said than done. There are things we don't wish to let go of so easily. There are changes we have difficulty accepting. We are held back by guilt. There are things we choose to put up a big fight against. There are also things we let inside our lives that maybe we shouldn't.
The stage representing "opposition and resistance" to change (wind) is the Large Intestine Primary Channel. When the Lungs fail to "release" a pathogen, it is passed onto the Large Intestine where it is transformed into heat and dampness. This signifies a struggle is occurring. From the struggle, heat (resistance and agitation) or damp (confusion) manifest. When we oppose or fight against something, the struggle requires a greater amount of energy to finance it. Ying qi (blood and fluids) must be transformed into wei qi. This leads to consumption of ying qi: as a result of the war being waged, we become blood and fluid deficient, which then leads to greater symptoms of heat. Dampness can turn into phlegm, inflammation can lead to reckless blood (bleeding and emotional instability).
This phenomenon, occurring at the level of the Large Intestine Primary Channel, is both a physiological fact as well as a poetic metaphor. The struggle occurs at the level of the head. A lack of acceptance (a virtue of the Lungs) leads to conflict. Conflict leads to friction, which causes consumption. It is largely played out in the head.
The ancients attributed rapid aging to opposition, transformation and consumption. The Large Intestine channel is the beginning of degeneration. The level of the Lungs allows possibility of acceptance that comes from forgiveness; the Large Intestine is the fight (resistance to change) occurring within our heads.
The Large Intestine channel travels into the nose: an orifice often associated with "heaven." However, as the channel connects to the Stomach Primary Channel via its last point: Large Intestine-20 "The Welcoming of Fragrance," the channel affects all the sense orifices of the head: the ears, the mouth, the eyes.
A Tai Yang condition transforming into "Yang Ming of the channels" will affect all the sense orifices of the head. This can be seen as a philosophical statement illustrating that we don't like what we are seeing, hearing, sensing. Symptoms of headache, red eyes, dry lips and mouth, sneeze can all be seen as psychosomatic expressions of our inability of acclimate to the environment: the inability to accept and let go. Instead, we begin to fight and resist what is happening, creating Bi-obstruction of the head. This is the beginning of fixation.
Rather than see the world as an expression of ourselves, we see it as being against us; something we must fight against. We begin opposing heaven, closing our noses from smelling the flowers, closing our ears from hearing the birds sing. We don't like the way the wind is blowing, so we decide to oppose it or walk against it. We put up great defense: fists up, waging battle with the elements. This reaction can cause us to become stuck. The exocrine fluids, meant to be like a river flushing out waste, become a sticky stagnant bog. The river dries up: dampness becomes phlegm, unable to move.
This is the stage where the neck and shoulders become important therapeutically. When we are fighting, the muscles of our neck and shoulders can become very tight. Loosening this tension is vital to releasing the head and chest: softening our defensive stance. Large Intestine-14, 15 and 16 are points on the shoulders that treat phlegm: heat (resistance) that has stagnated the flow of the waterways. Large Intestine-17 and 18 open the throat: the site of transformation of wind and cold into heat; also the area that "opens" the senses and mediates movement within the four limbs. Distally, Large Intestine-4 opens the head, Large Intestine-10 transforms wind-cold that is stagnating into wind-damp: the sense of confusion about acceptance and letting go. Large Intestine-5, the Jing River point, treats manifestations of dampness and heat affecting the Shen: the rigidity, confusion or manic expression of our resistance as we fight with the environment.
The rigidity created at the level of Large Intestine is clinically seen as "clumping of qi." This concept was first presented in Chapter 5 of the Ling Shu: the discussion on Roots and Terminations. In this chapter, pathological progression within the wei level is discussed relating to the Sinew Channels.
The Yang Sinew Channels travel from the Jing Well point on the digits into the head. A condition from the exterior not resolved will eventually stagnate in the sense orifices: the termination points of the Yang Sinew Channels. The sense orifices are naturally moist, bathed with the Jin (exocrine) fluids. The senses are "portals": they receive information from the external environment, as well as discharge material from the interior of the body.
The Large Intestine channel describes how resistance essentially closes our senses. Our head becomes "tied up." This imagery is described through the main pathway of the Stomach Primary channel, which begins at the nose (Large Intestine-20), travels to the eyes (Bladder-1 and Stomach-1), meets at the ears (Stomach-7), the mouth (Stomach-4) and eventually ends at the head (Stomach-8). A translation of the point Stomach-8 is "Head Tied." After visiting all the sense orifices of the face, the ultimate result of blockage in these portals is stasis within the entire head. The body has no choice but to internalize the problem, which occurs at the next point: Stomach-9 on the throat, and Stomach-12 on the chest. That which remains unresolved in the head, moves into the throat and chest: internalizing from being an external condition into an internal condition. Wind-cold becomes internal heat and damp. Something outside of us takes residence within: it becomes part of our lives, living with us. It is like carrying the corpse of someone who has died on our backs (or in our chests), unwilling to let them go. Obviously this weighs us down.
Clumping creates a type of pressure chamber. The head and sinus area may feel like they want to explode. The throat feels like there's the pit from a plum stuck there, the chest and diaphragm get tight: causing rebellious qi like coughing, sneezing, nausea or vomiting. The qi that is clumping is wei qi, which controls all cyclical movement in the body: breathing, sleeping, peristalsis. All these functions can become affected by "clumping."
We experience all these symptoms when we get a cold or flu. The root of it can be purely physical. It can also be a psychosomatic reaction to our environment: the inability to embrace and accept what is occurring. The Nei Jing states that grief affects the Lungs. What is grief but the process of letting go? It is a natural process. However, if there is clumping, and the grief turns into fixation and a fight, progression and transformation will occur, leading to consumption and transmission. Tai Yang will become Yang Ming. If it is not resolved, it will become Shao Yang: stuck between the external and internal levels of the body - representing confusion and/or unwillingness to either let go or embrace. Eventually Tai Yin will occur: the qi and blood of the body will become consumed.
The Large Intestine can get caught up on the issues of fairness and justice. When the Large Intestine becomes "constipated," it can express itself through behavior. Acting out through behavior (or posture) is often associated with the Divergent Channels. The role of Yang channels is to move. When they become stagnant, phlegm is created. Psychologically, phlegm is seen as unconscious material.
When something is repressed, as occurs within the Divergent Channels, it expresses itself through behavior. The behavior associated with the Stomach and Large Intestine Divergent Channels is spite and vengeance: trying to get even. The Stomach comes before the Large Intestine in the Divergent channel continuum. Spite can be seen as a mental process: obsessing about wanting to get even, often expressed in small passive aggressive ways. Whereas vengeance can be violent and direct: wanting an eye for an eye. There is the saying however that "an eye for an eye makes the whole world blind." This type of behavioral acting out certainly ends up hurting the person doing it. Rebellious qi disrupts assimilation, disturbing the descent of Stomach qi: necessary to ripen and rot food to allow the Spleen to transform and transport. Acting out is a form of rebellious qi that disrupts proper metabolism physically and psychologically.
The Divergent Channels are examples of extreme resistance coming from repression. Their expression is less conscious than that which is circulating through the Primary Channels or Luo Vessels. This is a level where resistance has turned into denial, becoming part of a person's disposition instead of remaining a conscious choice.
It is difficult to change that which we are not aware of. Our fixations may appear to us as part of our personality: who we are; something we cannot change. Physically, this is the level where pathology is literally "in our bones," affecting our marrow. Those around us may witness our innocence transformed into bitterness, pessimism and defensiveness. That which we are harboring within is disturbing the proper dissemination of our essential qi, creating personality changes: a term known clinically as "Zang Zao."
Any condition has the potential to move into the level of the Triple Heater Primary Channel: the envoy of essential qi as it is distributed into the Zang organs. All yang channels have convergence points that meet with Triple Heater. If a pathogen is strong enough, or we lack the capability and resources to release the pathogen, it can move into latency.
Latency occurs within two basic levels in the body: the blood and the bones. Within the Primary Channel progression theory, latency occurs at the level of Small Intestine. The "loss of latency" is represented by Triple Heater. The Bladder, Kidney and Pericardium channels lie between these two events. Yin and Yang become taxed by latent pathogens, threatening to disturb the "spirit-disposition." The Pericardium Channel is classically associated with "Zang Zao," a term translated as "visceral agitation" or "visceral dryness," and associated with changes in the personality. Pericardium and Triple Heater are channels whose role it is to maintain proper communication between the Heart and Kidney: the spirit and the essential self.
When an issue is not properly released: when we lack acceptance, forgiveness, and the virtue of letting go, it threatens to move into latency. First it will travel into the Luo Vessels, manifesting as Bi Obstruction, rebellious qi and Shen disturbances. If the pathogen becomes too much for the Luo to handle, it can be passed onto the Divergent Channels, moving from a state of suppression to one of repression. A Divergent Channel is considered a type of "Luo Vessel," but at a deeper level, now affecting the Jing and manifesting in more extreme symptoms of Bi-obstruction, rebellious qi and Shen disturbances (such as Zang Zao).
The Primary Channel progression theory illustrates the process of resistance, fixation and possible redemption. By the time of the Triple Heater Primary Channel, the body begins to lose its capacity to keep repressed material hidden and tucked away. It comes out into general circulation. By this time however, the body has become highly deficient, lacking the ability to manage or resolve the problem. The last yang channel in the Primary Channel continuum, following the Triple Heater, is the Gallbladder: the body's last chance to let go and move on.
It is curious that there are so many points along the Gallbladder Primary Channel with the word "yang" in their names. By the level of the Bladder and Kidney Primary Channels, the yang of the body has become damaged. Gallbladder-35 "Hui Yang" nicely describes one of the main roles of the Gallbladder Primary Channel within this stage of pathological progression. The name "Hui Yang" means to gather and consolidate the yang. It is a point that lies along the trajectory of the Yang Wei Extraordinary Vessel.
Yang Wei Mai is a channel relating to the "cycles of 7 and 8," discussed in Chapter 1 of the Su Wen. As we move through life, there are essential changes that occur in each of our lives: rites of passage. These are times of letting go of aspects of our lives (and our selves) so we can move into new eras. The Wei Vessels can become affected by traumas and disappointments in our lives: time periods where we become "stuck in time." This can manifest as damage to the blood and yin (Yin Wei Mai) or the qi and yang (Yang Wei Mai).
Gallbladder, as our last chance for resolution of fixated stagnant issues, gathers as much yang as possible to give us capability to move on and let go. Being a Curious Organ, the Gallbladder allows passage into the other Curious Organs, including the Brain and Uterus ("the Bao"). That which we are unable (or unwilling) to resolve in this life becomes the seed our next incarnation, or is passed onto the next generation (depending on your point of view).
The Gallbladder Primary Channel also connects to Dai Mai and Yang Qiao Mai. There is passage into (and out of) the chest (blood level) via Bao Mai, the uterus and genitals (via Dai Mai), the bones (via Yang Qiao Mai) and the Brain (via Yang Qiao and Yang Wei Mai). Gallbladder is a profoundly dynamic channel, with the ability to essentially decide the future for ourselves and our offspring.
Gallbladder is classically associated with courage, acknowledging the fear surrounding change, especially fundamental changes that come with aging. The theme returns to that of the Lungs and Kidneys: the will to breathe in and embrace life and all its changes. The process of the Kidneys "grasping" Lung qi is essentially embracing the uncertainty of life and choosing to live it anyway: allowing the Lung qi to combust the Kidney Jing and allow life to unfold however it has been destined.
Contained within our Curious Organs is the courage to face life and ourselves. We can trust in this. The Qiao Vessels (constitutional "curious" vessels) represent the courage and willingness to "stand up" to ourselves (Yin Qiao Mai) and the world (Yang Qiao Mai). Like the Divergent Channels, the Qiao Vessels circulate through the bones. It is through faith (represented by Kidney-8 "Jiao Xin") and the power to step and walk (Bladder-59 "Fu Yang") that we face life and all of its changes and keep stepping forward, connected to our essential selves.
References:
- Liansheng, Wu; Qi Wu (translators). Yellow Emperor's Canon of Internal Medicine. China Science & Technology Press.
- Mitchell, Craig; Ye, Feng; Wiseman, Nigel. (Translators). Shang Han Lun. Paradigm Publications.
- Yuen, Jeffrey. Channel Systems of Chinese Medicine: Divergent Channels. New England School of Acupuncture, December 21-22, 2002.
- Yuen, Jeffrey. Channel Systems of Chinese Medicine: Luo Vessels. New England School of Acupuncture, 2004.
- Yuen, Jeffrey. Channel Systems of Chinese Medicine: Extraordinary Vessels. New England School of Acupuncture, April 12-13, 2003.
- Yuen, Jeffrey. "Lecture on Divergent Channels" at Chinatown Wellness Center, NY, NY. June 19-20 and October 9-10 2010.
- Yuen, Jeffrey. "Lecture on Eight Extraordinary Vessels" at Chinatown Wellness Center, NY, NY, November 6-7, 2010
- 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 Latent Heat" at Chinatown Wellness Center, NY, NY. May 14-15, 2011.
- Yuen, Jeffrey. "Lecture on Luo Vessels" at Chinatown Wellness Center, NY, NY, March 20-21 and April 17-18, 2010.
- Yuen, Jeffrey. "Lecture on Phlegm": at Chinatown Wellness Center, NY, NY, March 5-6, 2011.
- Yuen, Jeffrey. "Lecture of the Primary Channels" at the Chinatown Wellness Center, June 20-21, 2009.
- Yuen, Jeffrey. Light on the Essence of Chinese Medicine: The Ling Shu. New England School of Acupuncture, December 16, 2000.
- Yuen, Jeffrey. Light on the Essence of Chinese Medicine: The Su Wen. New England School of Acupuncture, June 24, 2000.