J uly 2014

NAJOM

A Comparison of Dr. of life, then we can say that the meridian-channels

are the living structure or form for all the activities
“the channels determine life and death.” This can
be understood to mean that it is the presence or
Wang Ju-Yi’s Diagnosis and movements of living things.” absence of the channels that determines whether
through Meridian-Channel The standard translation of the mai or jing-luo
a person is alive. It also reflects the importance of
the health of the channels for maintaining optimal
Palpation and Early as “meridians” unduly emphasizes that they are
bodily functions. The state of the channels deter-
invisible lines on the body. They have therefore
Acupuncture Literature been easily associated with “energy,” without
mines whether a person will recover or succumb
to a serious illness. Dr. Wang has summarized the
paying due attention to their physical nature.
relationship between the internal organs and the
by Shelley Ochs Although the meridian-channels are not reducible
meridian-channels thus: “The five zang foster es-
to any one anatomical structure, they are a mate-
sence and therefore govern destiny, the channels
rial, substantial part of the living, human body, as
permeate and provide [substances], and therefore
well as the bodies of animals. The complexity of
Introduction the term jing-luo makes rendering it into English
they govern life.” (“五脏育精主命，经络灌渗主生。”)

Studying with Dr. Wang Ju-Yi has profoundly quite difficult. My current solution is to use the 2. 处百病 Harbor or Co-exist with the Hundred
influenced my understanding of acupuncture compound term “meridian-channel” to highlight Diseases
theory and practice, Chinese medical literature, the fact that they are both pathways that unify sets
of functions and structures, as well as conduits “The channels co-exist with the hundred dis-
the history of Chinese medicine, and even my
for material substances. I hope that this term eases.” This means that all illnesses, including
personal world view. In the last few years I have
captures more of the nuances of the term jing-luo those due to internal causes, external causes,
stepped away from the clinic to pursue a PhD in
in the work of Dr. Wang. injuries, or damage to the body through poor diet,
the history of Chinese medicine. In unexpected
lack of sleep, etc., influence and are reflected in
ways, these two areas of research have come
In his teaching and writing, Dr. Wang has empha- the meridian-channels. Disease or dysfunction in
together in the concept of channel palpation and
sized that we should keep two definitions of the the skin, vessels, flesh, sinews and bones, or in
channel diagnosis.
meridian-channels in mind: the first is that they the five zang and six fu, or the nine orifices will
My PhD dissertation topic was about Bian Que, are “gaps,” or holes or crevices within the divi- be reflected in the meridian-channels and can be
the legendary physician who may have lived dur- sions of the flesh or muscle that transport qi and treated through them. This may be one reason the
ing the Warring States period, about 500 BCE. blood; the second is that they are sets of functions, compilers of the Han Dynasty Ling Shu or Pivot of
As I began my research, I was struck by how the specifically, they move qi and blood, protect yin Efficacy named it thus.
early medical literature related to acupuncture and yang, lubricate the sinews and bones, and
and moxibustion described the vessels or chan- mobilize the joints. He has also described the lat- 3. 各有所长 Each Component of the Channel
nels as objects of palpation. In fact, the process ter as “a system for the supply and metabolism of System is Responsible for Specific Aspects of
of the formation of the concept of the channels substances that works through multiple pathways the Functioning of the Organism
and their use in clinical practice that we find in a and multiple levels of the body.”
This short statement points to the heart of channel
mature, sophisticated form in the Su Wen and Ling
Dr. Wang has elucidated the nature of the channels theory. It is necessary to have the preceding view
Shu, bears a striking resemblance to the concept
in both modern and classical terms. Here I want of the nature of the channels in order to appreciate
of the meridian-channels developed by Dr. Wang
to focus on his understanding of the following the meaning and significance of the six qi or six
through 50 years of practice, reflection, and study.
statement that we find in the Ling Shu or Pivot levels in acupuncture theory. In modern times, we
However, in a certain sense, his process has been of Efficacy. often focus on either the connections between
exactly the opposite of the historical evolution of the internal organs and the same-named channel
“经脉者，所以能诀死生，处百病，调虚实，不可不
the concept of the meridian-channels. Since he or a simple understanding of pathology along
通。”（灵枢·经脉）
was born in modern times, when the concept of the pathways of the channels. Dr. Wang’s work
the channels as carriers of qi and blood and their “Because the meridian-channels determine life provides us with a way of utilizing the principles
links to the internal organs are emphasized, it was and death, harbor the hundred diseases and of qi transformation, including the patterns found
Dr. Wang’s clinical experience and his study and regulate emptiness and fullness, they cannot be in the Shang Han Lun, and making them relevant
application of the concepts and methods we find blocked.” for acupuncture diagnosis and treatment.
in classical acupuncture literature that led him to
This pithy statement reminds us of the funda- We can divide the channel system into six sets
“rediscover” the principles and clinical efficacy of
mental principle behind acupuncture: keeping of functions. For example, the hand and foot tai
channel palpation.
the channels open is the key to health, disease yin channels are responsible for moving water
and longevity. We can examine each section of and transforming dampness and transforming
Dr. Wang’s Understanding of the this statement further. and regulating qi. The hand and foot shao yin
Nature of the Meridian-Channels channels drain fire and clear heat, and open
王居易老师对经络的认识 1. “诀死生” Determine Life and Death and penetrate the yin collaterals. The hand and
foot jue yin channels nourish yin and calm the
如果把有形的脏腑、器官、组织看作是生命的物质基 Concepts of life and death differ significantly
shen-spirit, and nourish blood and regulate the
础，则经络是生命活动的存在形式”（王居易，未病, across eras and cultures in the world. In early
channels. The hand and foot tai yang channels
第330页） Chinese civilization, the meridian-channels were
warm yang and relieve the surface, and raise yang
part of a tapestry of concepts about the nature of
“If we consider the zang-fu, the organs and other and disperse cold. The hand and foot shao yang
living beings and their place in the world. There-
tissues with tangible form, to be the material basis channels regulate the qi dynamic and course and
fore, we find the statement in the Ling Shu that,

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 NAJOM volume 21 number 61

open bindings and stagnation. The hand and foot 是主[肺] 所生病者（为此脏所主疾病，疾病例举） the early acupuncture literature. If we compare
yang ming channels ferment and transform water 气的状态（气盛，少气，气有余，气虚）病因… these excavated texts with the received version of
and grains (food) and guide out waste. 治则“为此诸病，盛则泻之，虚则补之，热则疾之，寒 the Ling Shu, we immediately see that almost all
则留之”等。 of the ailments were added under “suo sheng,” or
Channel Pathology in Wang Ju- “shi zhu” as Dr. Wang prefers to designate it, the
In 1988, Dr. Wang published an article with his sections related to the disorders that a channel
Yi’s Thought and Practice interpretation of the meaning and the clinical can treat (see table below). The author believes
王居易理论及临床中的经络诊查 significance of these passages. After his article there are two possibilities for this phenomenon:
“经脉者，所以能诀死生，处百病，调虚实，不可不
was published many physicians wrote to him to one is that the shi dong ailments were based
通。”（灵枢·经脉）
thank him for clarifying this problem and giving on channel palpation and as it was replaced by
them an interpretation than could be applied in palpation of the radial pulse, this mode of diag-
“Because the meridian-channels determine life clinical practice. He explained it thus: 是主[肺] 所 nosis was gradually abandoned; the other is that
and death, harbor the hundred diseases and 生病者. “It is this one that controls the ailments the ascendency of zang-fu diagnosis led to less
regulate emptiness and fullness, they cannot be generated by the [x-zang]. [List of ailments],” emphasis on “channel diagnosis,” at least in the
blocked.” should be understood to mean “this channel extant medical literature.
and its acupuncture points treat the following
Channel palpation relates to the second half of
ailments” and can thus be abbreviated as “this
the statement above. It is important to have a Meridian-channel Palpation and
channel governs” (是主).
clear idea of channel pathology and its manifesta- the Development of the Concept
tions before we attempt to use the channels for The parallel phrase, 是动则病 “When this one of the Channels
diagnosis. An important pillar of Dr. Wang’s acu- moves, there are thus ailments of…” should be
puncture theory is the differentiation of reactive Research on the Yellow Emperor’s Inner Canon,
understood to mean “abnormal changes in this
channels, which reflect disease and disharmony as well as excavated medical texts such as those
channel produce or indicate ailments of….” This
in particular patients, and the treatment channels found at Mawangdui in Hunan, China, suggests
is also in accord with the Song Dynasty scholar
for patients, which primarily regulate the six levels that palpation of multiple areas of the body de-
Shi Song’s definition of dong as “changing the
and treat ailments along the channel pathways. termined the sites for bian-stone, moxibustion,
original state or position of an object; resonance.”
This distinction is rooted in both his interpretation or needle therapy, and the results obtained led
The author of the Ming Dynasty Classified Canon,
of the sections of the Yellow Emperor’s Inner Canon to the further elaboration of the connections
Zhang Jie-bin also wrote, “ ‘Moving’ refers to
related to channel pathology and knowledge of the between the upper and lower body. Initially, ob-
change, changes that alter the normal conditions
correspondences between symptoms, palpable servations of palpable and visible blood vessels,
cause ailments.” This relates directly to using the
channel changes, and effective treatment points skin temperature and texture, and pathological
findings gleaned from palpation of the channels
accumulated over 50 years of practice. changes in skin and soft tissue were correlated
as the basis for acupuncture treatment. Dr. Wang
with ailments and effective treatment sites. This
succinctly summarized this idea thus:
Channel symptoms are systematically recorded eventually culminated in a system of channels and
in the “Jing Mai” chapter of the Ling Shu. Each “The theory of ‘ailments caused by abnormal collaterals that incorporated ideas from astrology/
channel is described under the following rubric: changes’ (shi dong) in the meridian-channels astronomy, calendar science, musical theory,
经络症状在《灵枢•经脉》篇中有系统的描述。每条经络
tells us that any illness or pattern (zheng) will and multiple views of the internal and external
都在以下标题后有描述。
inevitably cause abnormal changes in the chan- structure of the body.
nels. The disease, pattern or symptoms can be
• Name of meridian-channel Many different diagnostic techniques involving
diagnosed through the four examinations (looking,
body palpation and observation are recorded in
inquiring, listening/smelling and palpating), the
• Origin (site near the ankles or wrists) the early acupuncture literature in China. Many of
latter can only be determined through palpating
these techniques are not a part of the mainstream
• Pathway the channels with the techniques of observing,
practice of Chinese medicine in either China or
pulse diagnosis, palpation of channel pathways,
• 是动则病 “When this one moves, there are Western countries today. However, evidence sug-
pressing of points, and feeling the surface of the
thus ailments of…” gests that body palpation was once considered to
body.” 1
be the critical link in the process of choosing the
• 是主[肺] 所生病者 “It is this one that controls
“‘是动’ 病候理论表明，任何疾病或证型的出现，必 most effective channel and technique to relieve
the ailments generated by the [x-zang]. 然伴有经脉异常的出现。 前者通过‘望闻问切’可以 bodily pain and ailments. The author, and some
[List of ailments].” 获得，后者则通过对经络的 ‘审、切、循、按、扪’
scholars in China today, are convinced that physi-
才能确定。”
• States of qi [excess, vacuous, effulgent, cal palpation or observation of pulsating vessels,
insufficient] cause ailments of… small blood vessels, skin tone and texture, and
Historical Context other pathological changes in the skin and soft
• Treatment Principles “For all these ail- tissue were essential in the early development
Due to the discovery of the Mawangdui and
ments, one should needle quickly if there of acupuncture theory and practice. The channels
Zhangjiashan medical manuscripts in the 1970s,
is heat, retain if there is cold..” etc. as we know them today were originally conceived
we can now trace these passages from the Ling
经络名 of as palpable and observable blood vessels that
Shu to older texts and thus see the evolution of
起点（踝、腕周围） the development of the concept of the channels could be used to diagnose and treat ailments. Over
循行 over a several-hundred-year period. Dr. Wang’s time, the concept of the channel system as one
interpretation is further justified if we consider this continuous circuit came to define acupuncture
是动则病（若此运动，则会生如此疾病…）
historical development of “channel symptoms” in practice and the channels were seen as carriers

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J uly 2014 NAJOM

of qi and blood with links to every location and Channel Palpation and the Future Shelley Ochs received her PhD in the History of
function of the human body. Palpation and the sub- Chinese Medicine and Chinese  Medical Literature
Development of Acupuncture from the Academy of Chinese Medical Sciences
sequent codification of the information obtained
in Beijing,  where she is now a researcher and
from it were critical steps in this historical process. Over time, palpating multiple sites on the body
translator at the Research Centre for the Protec-
in order to determine acupuncture treatment tion of Traditional Knowledge of Chinese Medi-
This is important because it tells us something was mostly abandoned. The ascendency of organ cine. She is a practitioner of traditional Chinese
about how physicians in Han and pre-Han times (zang-fu) manifestation theory and herbal medi- herbal medicine and acupuncture, and has
conceived of the nature of the channels and their cine led to the exclusive emphasis on palpating completed  traditional apprenticeship training
effective use in relieving human pain and suffering. with senior acupuncturist Dr. Wang Ju-yi in. She
the wrist pulse and observing the tongue. This
Understanding the origins of the channel system has published on the history and application of
situation became particularly extreme in the 20th acupuncture in both Chinese and English.
may help us to more skillfully utilize it in clinical century, when we can say with no exaggeration
practice today, and it may also point to fruitful that mainstream education in China and the West
ways to develop and expand its use in the future. has been engaged in a process of “herbifying”
Examination of the pulses, mai zhen, in early acupuncture theory and practice. Fortunately,
Chinese medicine originally involved palpation at Dr. Wang Ju-Yi has revived and expanded chan-
multiple sites along the mai (vessels), or what later nel palpation and has shown us how it leads to
came to be known as the acupuncture channels. outstanding clinical results.
In the Ling Shu, (jiu zhen shi er yuan) it states, As a practicing clinician, I find that the textual
“If one is planning to use needles, it is essential resources on channel palpation are further con-
to first examine the mai (meridian-channels).” firmation that acupuncture must be rooted in
Several other passages in both the Ling Shu and a physical, visceral understanding of how the
Su Wen explicitly describe using a variety of hand channels manifest and change in living bodies.
techniques to examine various sites or channels in
order to determine where to needle. For example:
Notes
• “Those who use needles must first inspect the
1. 王居易，“经络病候初探”，中医杂志. 1988年(4): 11
channels [jing-luo] for emptiness or fullness
[xu-shi, deficiency or excess]. Separate and
follow, press and flick, and see which moves
under examination. Then, take that one and
needle into it.” Ling Shu (zi jie zhen xie lun)

• “Therefore, when puncturing those with

impediment (bi), one must first separate
and follow the lower six channels [i.e. leg
channels], seeing whether they are empty
or full [xu-shi], ...then adjust them.” Ling
Shu (zhou bi)

• “Examine, separate, follow, glide along and

press, and notice whether they are hot, cold,
flourishing, or in decline, then adjust them.”
Ling Shu (jing shui)

• “One must examine and inquire about how

the ailment began, as well as the state of
the ailment today. Then, separate and fol-
low the pulsations, noticing whether the
channels [jing-luo] are floating or sinking.
Follow upwards and downwards, moving
with and against [the channels]. Those with
rapid pulsations are not ill, those with slow
pulsations are ill. Those with no pulsations
moving back and forth will die. Those with
translucent skin will die.” Su Wen, Chapter
20 (san bu jiu hou lun)

• “As to the number of punctures, first inspect

the channels (jing-mai), separating and fol-
lowing. Determine emptiness and fullness
[deficiency and excess] and then adjust them
accordingly.” Su Wen (miao ci lun)