tisdag 31 maj 2011

Chinese medicine and awareness: the demand for good presence if you work with acupuncture

Chinese medicine demands a high level of presence and awareness. The more relaxed awareness the practitioner has, the better they will be able to treat a patient. The less they have, the less the treatments will work as the full version of classical chinese medicine can work to increase health and balance in the patient.

Chinese medicine has a close relationship with spiritual training. The oldest versions of it from 2500+ years ago is simply Daoism and the daoist medicine. Then this seems to have shifted about 2500 years ago to slowly become a separate chinese medicine, Classical Chinese Medicine, CCM. This in turn shifted into a new version from the 1950´s and onwards with what is called Traditional Chinese Medicine, TCM. From TCM, fragments have been created into various versions of Western acupuncture in the West. For each step, the skills in awareness and the precise training-techniques that builds it has been lost.

All these versions still exist today, but Daoist medicine and Classical Chinese Medicine are rare, and only few practitioners know them. However, there´s a surge of interest among Western acupuncturists for the original, old skills, so maybe they will be kept alive still (see another post for the Guild of Classical Chinese Medicine). The most common to find is TCM, while the more watered down versions of Western acupuncture are spreading inside the Western healthcare system.

The amount of information that a skilled acupuncturist uses while diagnosing a patient is stunningly big. But even once learned and seamlessly used, this can easily become a filter between the practitioner and the patient, and good awareness-skills are crucial to actually see the patient in front of you. The more relaxed and clear presence the practitioner has, the easier it will be to do a deeper diagnosis and create a more effective treatment plan.

In Daoism, a key phrase is bianhua, change. It is part of the core teachings of Daoism. Since millenia back, it has become an equal key factor in Chinese medicine, completely permeating Chinese medical thought and treatments. Daoism uses specific meditation-techniques and qigong to build up a stable, healthy body with a growing awareness and balance in the practitioner. The more relaxed awareness a practitioner has, the more clearly they can see how change arises in waves, culminates, and then flows into the next change. With time, with training, you start to perceive the how change weaves together in the long run, in the larger space. This is part of the Daoist training to slowly clean up and see through the red dust, hongchen, referred to in the phrase from the Daodejing, the Classic of the Way and the Power, ”Who can make the muddy clear? Let it be still, and it will become clearer.”

Experience with patients will increase the awareness somewhat, but to really train relaxed awareness to the precise tool it can be, a combination of sitting meditation and qigong is usually needed.

Qigong gives good physical health and builds more energy in the system, which is something that supports awareness. Just the sitting practice without qigong will be a help, but also lack the stability and support that qigong gives. It´s like an acupuncture clinic or an acupuncturist: they both have to stand on the earth to work.
A safe, stable practice of meditation and qigong helps to keep the practitioner´s awareness polished and clean as the years and patients go by. Like in many other fields, it´s not a question of being able to do it in the short run, the difficulty lies in keeping or increasing that skill over time. Buddhism says that we are like mirrors where dust has gathered, making us unable to see the light inside the mirror itself. Meditation gently brushes away the dust and lets us see the light that was there all the time. Awareness for good Chinese medical skill is the same: it has to be polished and gently cleaned each day to keep it bright.

A trained, relaxed awareness will make the treatments have a stronger and much more precise effect. This becomes even more important as treatments go on and the initial change has been set in motion. To accurately see the patient´s system – energy, mind, body, and all the diagnostic information as well as what weave that can be made in that pattern – demands very good awareness, otherwise the changes shifting in it might be missed, and the chance to tailor the treatment for better effect quite easily be lost. The treatment will still help; the question becomes how much more it could have been adapated for that patient and how much deeper the balance could have gone in their system.

For every needling, the method is above all not to miss the rooting in the spirit.”
Larre and Rochat, Rooted in Spirit, a translation of Chapter 8 of
the Neijing Suwen

This sentence illustrates Classical Chinese Medicine and its views on treatment. With a stable and relaxed awareness that is highly trained, the acupuncturist will be more able to diagnose the spirit and the emotional and mental states of the patient, and with rather more clarity choose which treatments will balance them and weave together with their health and surroundings. Without good awareness skills, these levels of Chinese medicine will remain locked to the practitioner. (The quote also goes into the use of intent in Chinese medicine, a basic skill of Classical Chinese Medicine and something we will look deeper at in future posts.)
The ability to diagnose through higher energetic sensitivity and awareness is echoed by the author of Shang Han Lun, the herbal text from 200 AD on how cold-related illnessess are treated. Zhang Zhongjing says, in his famous quote:

"The skilful doctor knows by observation, the mediocre doctor by interrogation, the ordinary doctor by palpation."
Zhang Zhongjing, 200 AD, author of Shang Han Lun

(A view recently echoed by Jeffrey Yuan during his conference. A post reporting on his conference about the Divergent Channels is coming soon). A skilled practitioner of Chinese medicine will, to quote Jason Robertson from his and Dr Wang´s book, of course use and have clinical skill in all three. But in the long run and the more skilled you get, the more you can diagnose just from the techniques of awareness, and through more clearly seeing the diagnostic signs in the patient.

You can become aware of and notice so much, even before that first touch.

Daniel Skyle © 2011

Rain over London

A poet once wrote a line that was immortal, but I have forgotten it.

Rain fills London. The city becomes a city of light: all surfaces catch a holiness that normal days hide away from us.

Stillness fills the dead angles of chimneys, corners, nooks, crannies and thoughts. The rain brings us these blessings: it makes the eternal city a place of rest.

lördag 21 maj 2011

London 2011: spring, sunlight, ambulating chinese medicine diagnostics

There´s a woman with a huge afro on the bus. She sits reading, and then sometimes starts talking to herself. Probably a bluetooth cell, I think to myself. But as she leaves, I see that her ears are empty.

In the mornings, the homeless stand in central London selling Big Issue. I buy them coffee, sometimes, and one I have to remember to buy hot chocolate if I do it again.

Sun is here now, warmth and joy from a long winter. The city and all its strange surfaces are lit by light, sometimes sharp, sometimes fading, sometimes in slits of cut light that falls through trees and rooftops in the afternoon as the crowds fade into evening. So many surfaces here, so uncountably many, of all kinds and all sizes. From the most rugged old stone that Shakespeare once walked on on his way to a play, to plastic, glass, metal, grained brick and old Victorian red brick with flutings inside it. Some sidewalks are paved with many different kind of paving stone, and the light plays on them all to make a symphony of the city before it starts playing beautiful solos on the cheekbones and hair of women walking by.

Crowds mingle and whirle in the pool that is Leicester Square and Piccadilly. Under the neon lights groups of tourists drift aimlessly, tired after yet another show, yet another place; in Chinatown the scent of food drifts through crowds that walk under chinese characters and past Chinese residents of these few blocks that are so much in height, in depth, than the rest of London. Nearby, Soho draws crowds for another trade, and for clubs, pubs and parties in nights longer than all the days of your humdrum working life ever were.

I buy good coffee, stroll, buy books; sit on buses, drift through crowds. Go through Chinese medical principles, apply them on my surroundings; do instant diagnosis on bystanders, on pedestrians, on two cops while sitting on a double-decker bus and looking down on them from above.

On Trafalgar Square, Nelson´s statue still stands on the tallest pigeon-nest in the world, while a digital clock ticks and tocks down the minutes, hours and days until the Olympics arrive in London in 2012.

Sunlight. Green trees in Berkley Square, red buses filling streets with black cabs like little friends running next to them; voices on the bus, laughter, someone saying ”And it was really great sex” to their friend just as they walk past me; the old hippies in Camden and the man walking past with blue tattoos in his face, and long dreadlocks, looking like a misplaced Scottish traveller who walked into the maze of London and never got out.

Sunlight here. Warmth pooling in the alleways and streets of the city, making everything ready: summer is coming to town.

onsdag 4 maj 2011

Jeffrey Yuan, the meridian system and the Divergent Channels in acupuncture, and more on the difference between TCM and Classical Chinese Medicine

Classical chinese medicine and Daoism have many similar views of how qi, energy, makes us alive and which ways it flows in the body. I am going off on a conference on this and thought I should explain some basics on the lesser known aspect of the meridian system.

Méridien is probably the first usage of the word in the West, in French texts. It hints at the longitudinal and latitudinal web we have devised to keep track of where we are on the planet. But the Chinese term is not meridian: it is jingluo, a word that combines two different kinds of meridians and has quite a different connotation. The twelve main meridians are called jing, whereas luo is a smaller network all out through the body, much like the capillary network for blood. The word jing means net and have connotations of channels, like irrigation channels. To get that more organic idea, sometimes it has been translated into warp and weft in English, for the looms that weavers use, and the idea of a woven whole.

The luo are a network of smaller flows that link between meridians and then out into all parts of the body where the main meridians don´t go. There are specific points on channels called luoxue, luo points, that open and balance the link between that channel and the paired channel to make it smoother – LU7, Lieque, on the Lung channel, is luo to connect to the Large Intestine channel, KID4 on the Kidney channel is luo to the Bladder channel, etc.

After the first twelve main meridians there are the Eight Extraordinary Meridians, which we´ll do a separate post on later. Two of the Eight Extras are included in the main ones – the Ren and Du meridian, the Governing and Conception vessel (see earlier posts). Few Western acupuncturists are used to working with the other six Extras at all.

The conference I am going to is one the Divergent Channels (jingbie), and even fewer acupuncturists work with and use them, myself included. The conference is held by legendary acupuncturist Jeffrey Yuan, who is trained both in old chinese medicine and in Daoism, and knows some of the really old Daoist ways of using chinese medicine and acupuncture for patients. You can see his background here:

And two interviews with him here, the first of which is a discussion on how Chinese medicine can aid the treatment of cancer:

And a general Interview:

On this page, you can read a first intro to the Divergent channels:

The Divergent channels form a network that brings energy back into the internal organs from the extremities. They create deeper connections between the meridians. Yuan writes that he uses them for treatment of auto-immune diseases with acupuncture – you can read an intro on his article for the conference here:

Here´s a quote from it: ”The Divergent channels are a link between the External and Constitutional domains. Therefore, the Divergent Meridians have a focus that is quite specific in dealing with constitutional factors and they overlap somewhat with the Eight Extraordinary Channels. However, they also deal with the Exterior, which means that they also overlap somewhat with the Sinew Channels. These channels therefore make a direct connection between the external and the constitutional energetics (which are the marrow and bones). These channels therefore are the main ones when the condition relates to the bones and marrow. The marrow and bones conducts Yuan Qi, but as they also conduct Weiqi they are part of the external domain.

During this seminar we will see correlations between the Divergent Channels and the immune and lymphatic systems. We will see that these channels are among the most important for treatment of immunological conditions, from auto-immune to immuno-compromised illnesses.”

Few acupuncturists ever understand, even less work with these, so it will be very interesting to hear more about them in depth. One of the few books that try to specialize in them is Charles Cace and Miki Shima, The Channel Divergences, but at least this reader was a bit disappointed in how little was about the Divergent channels themselves and how much was devoted to various new systems of treating them using electro-acupuncture in Japanese acupuncture. Maciocia has a book that partially looks at them, but otherwise, knowledge and information about them is scarce compared even to the Eight Extras.

I´ll fill in this post with a report from the conference later.