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.
Renying-Cunkuo Pulse: The Essential Pulse Method of the Ling Shu
The Ling Shu is a Han Dynasty classic book on the practice of Chinese medicine. It presents five main channel systems: Muscle Channels, Chapter 13; Luo Collaterals, Chapter 10 and others; The Main Channels, Chapter 10 and many more; Separate Channels (Divergent Channels) Chapter 11; and the Eight Extraordinary Channels, referenced in chapters throughout the book (there is very little theory). These five channels are the terrain of the human body and the locations for treatment.
Identifying the Condition of Yin-Yang
The Ling Shu, Chapter 9, End and Beginning: "Please discuss, from beginning to end, the regulation of the main channels."
"One should know by taking the pulse at the Pulse Mouth (Lung 7 area, Cunkou), and the Man's Receptor (Stomach 9, Renying area), whether yin and yang are in excess or deficient, balanced or not balanced."
The Renying-Cunkou pulse identifies the condition of Yin-Yang within the body. An imbalanced pulse reveals that one of the Yin-Yang channels is in a state of excess and the other deficiency. Because Yin-Yang paired channels are inseparable both require treatment. Imbalances in a channel not only influence the channels identified by the pulse, they can influence the entire body. For example, blockages in a channel can prevent the circulation of qi and blood throughout the body, and pathogens in a channel can transfer to other channels and organs.
Identifying Channels to Treatment
Ling Shu, Chapter 3, An Explanation of the Minute Needles: "Don't just stare at the disease. Know its origins. First know what channels are diseased, then treat those locations."
Chapter 9 of the Ling Shu, End and Beginning, presents the Renying-Cunkuo pulse, which can be considered the first pulse to take. It identifies the imbalanced channels requiring immediate treatment. The Renying-Cunkou pulse compares the strength and quality between Renying/Stomach 9 area and Cunkou, Lung 9 area on the same side; the relative difference identifies the imbalanced channel. When the Renying pulse is one time stronger than the Cunkou pulse, the imbalance is Shaoyang. When it is twice as strong it is Taiyang, and when it is three times stronger it is Yangming. When the Cunkuo pulse is one time stronger than the Renying pulse the imbalanced channel is Jueyin, two times stronger it is Shaoyin, and three times it is Taiyin. In this pulse-treatment method the imbalanced channel and its Yin-Yang pair are treated.
Renying-Cunkuo Treatments
The Ling Shu presents a unique treatment method for treating imbalances identified with the Renying-Cunkou pulse. Three areas or points are selected. For Yang Channel imbalances: Taiyang, Shaoyang and Yangming, two areas/points are reduced on the imbalanced channel and one area/point is reinforced on the Yin-Yang paired channel.
For Yin channel imbalances: Jueyin, Shaoyin and Taiyin, one treatment area/point is reduced on the problem channel and two areas/points are reinforced on the Yin-Yang paired channel. For example, when there is a Shaoyang imbalance, reduce two areas/points on the foot shaoyang channel (gallbladder channel) and reinforce one area/point on the foot Jueyin channel (liver channel). Always reinforce first, and then reduce.
Locations to Treat
The Ling Shu, Chapter 9, End and Beginning, does not state which specific areas or points to treat, it suggests treating distant points. For example, for a Foot Shaoyang imbalance: "Use two dispersion points for one tonification. Treat once a day in accordance with examination and diagnosis. Treat distant points. When the ascending qi harmonizes, stop."
After years of exploring this pulse and treatment method I have found a few treatment strategies:
- Treat the transporting points that correspond to the condition based on the Ling Shu.
- Treat relevant points related to the condition on the imbalanced channels.
- Treat the source points on the imbalanced channels. Add the sea points if the pulse does not change.
- Treat imbalances along the entire imbalanced channels.
The name of chapter 9, End and Beginning, is guidance for treatment. The guiding principle is to evaluate the entire channel from beginning to end to identify imbalances (that strategy should also be applied to muscle channel treatments). In my experience, selecting from the listed treatment approaches to fit the uniqueness of each patient is the most effective treatment strategy.
Distinguishing Hand or Foot Channels
The Ling Shu presents a quality of the pulses that distinguishes whether the imbalance is in the hand or foot channels. For example, when treating a Shaoyang imbalance it is necessary to know whether to treat the hand or foot Shaoyang channel. The Ling Shu states: if the pulse is rough (restlessness, race, unsettled) it is a hand imbalance. Knowing this quality is essential in treating the correct channels.
Qi Arrival
The Ling Shu, Chapter 9, End and Beginning: "The total way of acupuncture is to harmonize the qi and then stop."
The Renying-Cunkou pulse presents a way to determine the duration of a treatment. After the practitioner completes the needling (or other method) he or she should check the pulses and when they are in balance, the treatment (Qi) has arrived; it is time to remove the needles. Removing the needles when the Qi has arrived is an essential aspect of this pulse and treatment method.
The Renying-Cunkou pulse and treatment method offers essential principles for the practice of Chinese medicine. First, it identifies the imbalanced channels. Second, only the imbalanced channels are treated. Third, always reinforce and reduce. Finally, check the pulse and when it is balanced the treatment is complete and end this portion of the treatment.
The Renying-Cunkou pulse is an essential part of the Ling Shu and classical Chinese medicine. This pulse and treatment method can enhance any system of Acupuncture. Hopefully, this article will inspire study and application of this classical pulse method.