Transcript of the Seminar: Acupuncture in Gynecology Gynecology and Neuromuscular Pain NGUYEN VAN NGHI, M.D. TRAN VIET DZUNG, M.D.
PRESENTED 17-18 SEPTEMBER 1988 © 1990 Jung Tao Productions
"If you want to develop acupuncture, if you want to make it grow and spread, you have to be very strict in the way that you learn things, rigorous or strict in the way that we learn the words. Because if we employ words which are not accurate, we are not going to learn anything. Because in chinese medicine, every single word has a deep meaning, and if we don't use them correctly, we may end up making errors. And if there are errors in comprehension we cannot help our patients, we cannot get results. And a medical science where there are no results is a science that has no future. That T hat is why we are very strict about the terminology. "
Dr. Tran Viet Dzung
"There are three things that I am sure about that I would like to explain to you in a very simple way: First of all, the further I get into my studies of acupuncture the more I realize how little I know, that I know nothing; Two: among my patients there are lots of failures, I fail to cure a lot of people. But there is one thing I am sure about: that if I don't succeed in curing my patients, it is not the fault of acupuncture: I haven't reached the height of my prowess, I haven't reached the peak of my possibilities and achievements. There is acupuncture and there are acupuncturists. Thirdly, I notice that often when I fail to cure someone, it's because I haven't properly grasped the technique; that is, I use a technique, often, that I haven't really understood. That's why I believe, that when you puncture a point in acupuncture, you have to understand the meaning of that action, you have to understand the meaning of what we do. We have to understand the deeper meaning of acupuncture. Because if you puncture a point, and you don't understand why you're puncturing it, if you're just doing it because the Chinese say s ay you that have to do it, or other people say you have to do it, if it's just a 'reflex' point, without any proper interpretation or real understanding, according to my experience, the results are not good. "
Dr. Tran Viet Dzung
FOREWORD These transcripts represent, in the most accurate fashion possible, the lectures of Drs. Van Nghi and Tran in, Bloomington, Minnesota, the 17th and 18th of September, 1988. The Doctors presented two full days of lecture on Chinese Medicine, discussing such essential topics as San Jiao energetics, treatment of cephalgias and traumas, of superficial perverse energy invasion, and, most especially, the energetics of gynecologic functioning and the treatment of gynecologic conditions.
ABOUT THE LECTURERS: NGUYEN VAN NGHI, M.D. is a member of the Council of Administration of the French Association of Acupuncture, Technical Director of the National Institute of Acupuncture in France, Director of Chinese Medicine in Lausanne, and President of the World Association of Acupuncture. Originally practicing both Western and Chinese medicines, in 1954 he devoted his medical practice to acupuncture based on the classic Chinese model. Dr. Van Nghi completed his medical studies at Monpelier in France, and is a graduate of the University of Marseilles. He has published Sémiologie et thérapeutique en médecine énergétique orientale and Pharmacologie en médecine orientale. His most recent efforts include a pediatric hospital in Marseilles and the release of his edition of the chinese medical classics, Maladies évolutives des 3 Yin 3 Yang (Shang Han Lun de Zhang Zhongjing) and Art et Pratique de l'Acupuncture et de la Moxibustion (Zhen Jiu Da Cheng) (the latter in 2 vols.).
TRAN VIET DZUNG, M.D. has collaborated with Dr. Van Nghi for fifteen years. Dr. Viet Dzung is a graduate of the Medical Faculty of Paris, and is in charge of the course in Acupuncture at the Faculty of Medicine in Marseilles, France. Widely published in European and American journals, he is Adjunct Editor-in-Chief of the revue française de médicine traditionnelle chinoise.
ABOUT JUNG TAO PUBLICATIONS: Jung Tao Publications is dedicated to the global dissemination of accurate study and application of classical chinese medicine. A non-profit educational corporation, all funds are devoted to further research in chinese medicine, and towards making further important works in this field available. We are committed to making accessible, in the English language and to the North American practitioner, much of what has heretofore been available only to the European practitioner.
Index
Day One: Saturday, 17 September morning session ..................1 Saturday, 17 September afternoon session ............................. 28 Day Two: Sunday, 18 September 1988 morning session ....... 44 Sunday, 18 September afternoon session ............................... 62
Day One: Saturday, 17 September morning session Dr. Sean Marshall: Good morning. I'd like to thank you all for coming. I'm sure we're all in for a treat here today. Our first speaker this morning is Dr. Nguyen Van Nghi. Dr. Van Nghi is president of the World Association of Acupuncture and a member of the Council of Administration of the French Association of Acupuncture. He has published over eighteen major textbooks on Chinese Medicine, and lectures throughout the world. We are very happy to have him with us today. And so, without further delay, I would like to introduce my long-time mentor and friend, Dr. Nguyen Van Nghi.
Dr. Nguyen Van Nghi Thank you Dr. Marshall. Sixteen years ago I came and spoke about acupuncture in this country. Today I am pleased and honored to have been invited to come talk about acupuncture again. You know that currently acupuncture is becoming very important in the world. And the United States really only began to learn about acupuncture fifteen years ago. This is why we've been invited here to talk about Chinese Medicine. This is a very heavy program. They have asked me to talk about gynecology, and our colleague Dr. Tran will be talking about the formation of the different types of energy. You know that in Western Medicine it takes at least five years to learn about gynecology, and here we're going to try to do a synethesis in five hours. But this is not a problem. We're first going to talk about female physiology, that is energetic physiology. This physiology includes the study of channels [meridians]; there are many of these channels: there are principal channels, secondary channels,... The secondary channels which concern the genital area of the woman are [of] the Ren Mai (Conception Vessel, CV), Chong Mai [Penetrating Vessel], and the Du Mai (Governing Vessel, GV); and in addition there are a couple of other channels which deal with the external part of the genital area of the woman. In order to study gynecology, therefore, we first have to study the problems of the external area, then, afterwards, the problems of the internal part. The channels which deal with the external part of the genital apparatus of the woman are the Tendinomuscular channels. Of this group of three types of channels, it is the prinicipal channels which are the most important: the channel of the Liver and the Gall Bladder, the channel of the Spleen and Stomach, and finally, the channel of the Kidney and Bladder. This is why we have to do a synthesis of all the channels.
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First we're going to talk about the Liver-Gall Bladder system. You know that the Liver channel begins at Li-1.
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metabolizes, the bowel plays a role of transit. The uterus, that is the curious organ, plays a double role, the role of receiving and the role of releasing, or giving back, expelling. That's why it's curious. It plays the role of both organ and bowel. As far as the Spleen and Stomach is concerned, in Chinese medicine it is a system of production and of transformation, of mutation--energetic mutation. In other words, the Spleen and Stomach constitute the system of the creation of human energy from food. this is why the St and Sp meridans (--that is the Stomach, that is the Spleen--), they pass through the genital area; when they arrive at the area of St-30, they send out many smalll vessels into the interior of the organism to nourish and support the uterus. the Spleen goes from down to up, when it reaches the area of the groin, to Sp-12, Sp-12 is situated 3 cun from CV-2. When the Spleen channel has reaches Sp-12, it sends a vessel towards CV2, to CV-3, and from there it penetrates deeply into the genital apparatus, to bring a very special kind of energy to this area, which we could describe as 'fertile energy', which is no more than humidity, because the genital organ of the female needs to be humid, needs to be moistened, to be fertile. We're now talking in terms of space, the sky: the heavens do not produce, they send heat. The earth is the element of transmutation, thanks to the energy which comes from the sky. This is why in Chinese medicine, when you have the word 'earth' it means mutation or change, in other words, you have to have humidity in order to create. We are on the earth, we are created as a result of earth energy, the plants,and animals have to go by the same conditions: in other words, substances which are created by earth and heaven energy are substances which are material, which you can see. Here, the humidity of the spleen penetrates into the uterus, which causes a kind of continuous transmutation, transformation. This is why the energy of the spleen plays an important part in the fertility of a woman. Now we're going to talk about the Kidney channel, Kidney and Bladder. It is necessary to know the Kidney channel in a very detailed way because according to Chinese theory the kidneys play a triple role : the first role is that of sexuality, procreation. Those of you who are MD's here will be surprised to hear that the Kidney plays a role in procreation. I will give you an example: if it is the case of a person who has a chronic nephritis, these are people who are always impotent. There is a bad spermatogenesis, that is, a faulty formation of sperm. Whereas normal people are capable of producing; Whereas people who have an insufficiency of the Kidneys always have a low sperm count, or not enough sperm. So the Kidneys play a role in sexuality, procreation. But in Chinese medicine the kidney also plays a very important role in thermogenesis. So in western medicine we would say that the kidney plays a great role in the production and conservation of heat in the body. Organic heat, because the term 'organic heat' is also mentioned in western medicine. But they do not know where this organic heat of the organism is produced. In Chinese Medicine they have proved that the
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Ki is the source of organic heat. It also plays an extremely important role in hydrogenesis, in other words it produces organic water and organic cold. Organic cold is also mentioned in western medicine To be more specific about the terms thermogenesis and hydrogenesis, the chinese speak of Kidney yang and Kidney yin, or if you prefer, Kidney heat and Kidney cold, or, alternatively, the fire of the Kidney and the water of the Kidney; all these terms are the same. But the Kidney also plays another very important role, which is in the formation of Jing, ie: the quintessence. Roughly speaking, there are three types of Jing: there is the Jing which supports and maintains the external layers of the body, eg: the skin, the dermis, the muscles, etc. The Jing also plays an important role concerning the orifices of the body, such as the eyes, the mouth, the ears, etc. It's thanks to this Jing that we can see, hear, small and speak. In western medicine, they speak of Ear Nose and Throat. Another type of Jing is the mental Jing. The chinese speak of the Po, the Hun, the Zhi, the Shen and the Yi, these are the seven sentiments or emotions of man--all of this comes from the Kidneys. This is why they give a special name to the Kidneys, they call the Kidneys the organ which is the Source. Remember among the five organs there is only one organ which has the name of 'Source', which is the Kidneys. So the Kidney is very important. I've already spoken to you about sexuality; when we talk about sexuality it means that the Kidney plays an important role in the formation of sperm, or in the woman of ovules. This is why we have to go into some detail with regard to the Kidney channel. The Kidney channel begins at Ki 1, below the foot, on the plantar surface of the foot. It ascends to Ki-10, from there it penetrates into the anus<> and it follows the anterior surface of the coccyx and the interior surface of the sacrum and the interior surface of the Lumbar vertebrae. When it reaches the area of the second Lumbar, it penetrates into the Kidneys; from the Ki it goes to the Bladder to constitute the system known as Yin-Yang, Ki-Bladder. When it has reached the Bladder it reaches the internal surface of the abdomen,
; when it reaches the peritoneum it makes a point, and from there it continues up the internal surface of the abdomen, reaching Ki-27, at that point. The whole pathway of the Ki, therefore, is on the interior surface, and not on the exterior part, because the Ki is a source, the source of water is from the interior, not the exterior--water comes from the interior, not from the exterior; (This particular path still has to be explained by the chinese, because that pathway of the Ki which is described by our colleagues the chinese is the Chong Mai and not the Kidney.) and then these points reach the exterior, because it's the source--they represent the well, the hole from where the water comes, it reaches the exterior. In another words, as a result of this situation, we can understand exactly the existence of the points. To the occidental mind, the point of acupuncture is a point; but to the oriental mind, the point is a canal, a channel, a very small channel. Another example to prove that 4
the point is actually a small channel and not a point: below the skin you have the 24 meridians, and the principal meridians send a lot of small vesssels, called secondary vessels. Secondary vessels don't have points, they follow the points of the principal meridians, but the principal meridians have points, and these points emerge on the exterior, for example, Bl-12, or whatever, SI-4. So the point is a channel and not only a point on the surface. This is why when you needle, in order to get good results in acupuncture, you have to penetrate into this opening and you have to slide the needle into the place where the point is on the interior. The chinese give [it] a name- you have to wait for Deqi to arrive: this simply means that you have to touch the point in the interior, and not just the point on the exterior. I have visited many different schools in the world; there are certain acupuncturists who simply put the needle on the skin when they treat, and the needle is hanging like that...in other words they are not going to get any results. If you don't get good results, it's not the fault of acupuncture, it's your fault. I've been talking about the existence of the Kidney points in the interior part of the abdomen. There, there is a channel called Chong Mai: we're going to talk about that in a moment. What does 'Chong" mean? 'Chong' means 'meeting place', or 'crossroad', in another words, these are the roads, this is a type of crossroads. So therefore the Chong Mai reaches a point and it joins up with other points, in another words with other crossroads or with other meeting places--in another words the Chong Mai really means 'meeting place on all the crossroads', but this way of thinking is too chinese--we're americans, so we say, it is the meeting place of the crossroads, the 'road to the crossroads'. To go from one area to another, you have to go through these crossroads. So we've just learned that from the Kidney channel is not really the Kidney channel, it's the Chong Mai. I've been speaking about the Kidney channel; I would ask you to try and understand very clearly this particular area, because in the diagrams you're going to find in Chinese editions it's somewhat vague. Because the Kidney is so important in its role as source, or Spring ... The Kidney sends a vessel towards the uterus to support and maintain the uterus, to control or commmand the uterus; after it comes out at CV-1, which is situated between the vagina and the anus, and from there it divides into two branches: an anterior branch and a posterior branch. The anterior branch is called the Ren Mai, the posterior branch is called the Du Mai. (Yesterday I showed Dr. Van Nghi an Outline of Acupuncture, the Essentials of Acupuncture) When you talk of curious meridians, such as the Ren Mai and the Du Mai, they [the Chinese] say that the Ren Mai and the Du Mai start off at CV-1. We're Americans, we have to know: where does this Conception vessel come from? Now we know--it comes from the Kidneys. If not, otherwise the physiology of the genital system is incomplete and not completely known. Now you know the origin of the Du mai and the Ren mai. But as I said the Kidney is the source, it plays a lot of different functions. 5
I just said a moment ago that the Kidney plays an important role in thermogenesis; that is Kidney yang. For we western people, we can compare Kidney yang to the surrenal capsule [adrenal gland], because all physical and mental activity depends on the surrenal capsule; whereas the word 'kidney', just 'kidney', in western medicine simply refers to an excretory organ. The Kidney sends out another branch, also very important, which follows the previous one; it follows the anterior branch up to the point CV-4, which we call Guan Yuan, 'Gate of the Source'; CV-4 is the place where the second vessel coming from the Kidney arrives; this is why this place is called the gate, or barrier, of the 'source'--'source' means Kidney. From there it divides A moment ago I explained about the Kidney points which are located there, but there is not a Kidney channel, there are points of the Kidney channel. This channel goes towards the Kidney channel and joins up all these points, until it reaches Ki-27; that's what's called the Chong Mai. So now you understand that the Chong Mai, the Ren Mai and the Du mai have a very important role to play in the genital apparatus of the woman, of women. But this is not enough. Because now you're specialists in gynaecology, now we have to study it in more detail. Above the pubic bone is CV-2. Here is the umbilicus, where the point CV-8 is found. The area between these two points--CV-2 and CV-8--is very important: when we speak about gynaecology we are talking about this zone, which is given the name of Tan T'ien, which literally means 'the area of the productive rice paddy'. When you go to China, for example, you see the rice fields, they are flooded with water, and above is the sun, the sun is Yang, down here is Yin. When there is a communication between Yang and Yin there is production, transformation and creation. This is why this particular area is called an area of procreation. It's a very important area, [which can be] compared to the rice fields which feed and nourish the people. But our french friends translate it by 'Cinnabar', which doesn't make any sense. Now, how to find these points. You have to divide [this area] into three parts. This is CV-4, Guanyuan; this is CV-6, with the name Qihai, 'Sea of Energy'; then you divide each part into two again, and you have CV-7, called Yinchiao; 'yin' means high, 'chiao' means 'meeting', 'reunion', so: 'the meeting point of water'. But the term 'yin' also refers to the uterus, also means 'uterus'. This is why CV-7 is used to treat sterility. Between CV-6 and -4 is CV-5, called 'Shimen', which means 'stone gate'. This point is a direct link to the Kidney. This is also the point where the San Jiao brings water to the Kidneys. Dr. Tran will talk this afternoon about the San Jiao, the 'Triple Heater'. Because in Chinese Medicine, without the San Jiao there would be no energetic system. Up until this moment, the San Jiao system has hardly begun to be known in China. They just tell you that it is the system which sends water into the different parts of the system. But how? 6
We're americans, we want to know why, how. And our colleague Dr. Tran will explain that later. After CV-4, there is CV-3. This is the front mu point of the Bladder. CV-4 is the front mu point of the Small Intestine. CV-5 is the front mu point of the lower Jiao. So you have to know the point, the name of the point, the meaning of the point and the function of the point. To study gynaecology and to get good results, however, it's a little more difficult than that. In all books, without exception, when there is a diagram of the Conception Vessel, that's the way it is; in another words, the diagrams which they present you are synthetic, artificial. But since we're specialists, we have to study it in detail. And to study them in detail we have to look at the older, or antique books, ancient books: for example in the Nei Ching Su Wen, in the Da Cheng--'Da Cheng' means 'The Compendium of All Acupuncture Techniques'. [According to] the Nei Ching Su Wen, the Ren Mai arrives at CV-3, it penetrates deeply into the bladder and the uterus; in other words, the point CV-3 is the front mu point of the Bladder, as I already mentioned, and it also brings water, or humidity, to the uterus. That is why, in certain cases of uterine inflammation, [with] sensations of heat and pain, to calm this pain, to stop this pain, we puncture CV-3, tonifying it. But now we're talking about physiology. We know that CV-3 sends vessels into the uterus, that is, internal vessels, which we call small secondary vessels, which we also refer to as 'energetic capillaries', and you have to know all this. Afterwards, it reaches CV-4, front mu of the Small Intestine. We know that the Bladder and Small Intestine together are known as the Tai Yang, so therefore that is the area, the zone, of Tai Yang. Tai Yang means 'water' or 'cold'. That is why, when the vessels from CV-3 arrive at Cv-4 they immediately go internal and irradiate around the small intestine. There is a sort of mesentery system which goes to the Kidneys; in other words, small vessels of the Small Intestine bring the water from the Small Intestine toward the Kidney by means of the mesenteric branch. And our colleague Dr. Tran will explain that in detail to you later, whereas here, I am just talking to you primarily about the importance of CV-4, because these two points are specific points for gynaecology. From there, the channel emerges at CV-5, CV-6, CV-7 and CV-8. That is, from CV-7 to CV-3 there isn't a line or a channel, there are only points, because the Ren Mai or Conception vessel comes from the Kidneys, from the source. And these points are situated on the interior, whereas the points that are on the exterior are points which are emerging from the interior. Now we are in the region of the abdominal wall. You can't needle through the abdominal wall to find these points, you'll bring about a peritonitis, so there's a special technique.
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the point.> You put the needle in, first of all, through the skin--you must not turn the needle while it's still at the level of the skin; if you're still at the level of the skin and you start turning the needle, it causes extreme pain--you will lose your client. And our profession involves keeping our clients. So you have to go through the skin, and you begin to make rotating movements, progressively, in and out movements, with very light fingers. Do it gently, not brutally. You keep pushing the needle in and suddenly you feel a slight resistance, this means you're touching the peritoneum. But don't go through it--you immediately pull back the needle, only about a milimeter or so, and then you begin to manipulate the needle, either to tonify or to disperse. Because in France, as in the States, there are some unskilled acupuncturists, clumsy acupuncturists, who go through the peritoneum and cause a peritonitis, or go through the thorax and cause a pleurisy, which is extremely serious. Naturally, in France there are medical laws, these acupuncturists are barred from practicing for life. I'm sure that it's the same in the States. This is why we acupuncturists have to be very careful--that can happen. When you puncture points on the back or in the thorax you [can] provoke lipothymia [faintness, syncope], there will be loss of consciousness. The needle can also go through into the thorax; we have to be extremely careful, both in the United States and in Europe: you should never needle people when they're sitting down, and never standing up. The patient should always be lying down or partially lying down. This is very important, because we're in the States, not in China; if the patient becomes unconscious, loses consciousness, you'll have to call the ambulance and the police. It happens in Europe. I'm sure it will happen here too. This is why: there are certain points which can very easily cause a lipothymia, for example, GB-21. Dr. Tran is going to talk to you about this. When you puncture it deeply and you turn the needle, if you do a quick manipulation it provokes abundant perspiration under the arm, subaxillary, a lot of perspiration. And then the patient becomes completely pale and falls over, and there is lipothymia. Fortunately, we acupuncturists have points which can bring the patient back to consciousness, reanimate the patient, we call it reanimation method, reanimation technique. I'm just doing some examples of points (if we went into a lot of detail we wouldn't do any more gynaecology): GV-26, St-36, and all the Jing-well points, the points situated on the extremity of the [digits]. The Jing-well point really means points which are at the ungual angle [i.e., corner of the nail] of the digits. That is, the first Su-Antique point.
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I've just talked about the Kidneys, the area Dan Tien. Now we're going to talk about the Bladder. At the level of the coccyx and the sacrum, exactly where the sacral foramina are found , each of these holes has a point: Bl-31, Bl-32, -33, -34, and -35, and the channel circulates You have to know these points by heart, they're very important points in gynaecology, especially in gynaecological conditions where there is extreme pain caused by serious conditions in the uterus, or in less serious problems--because most of the men here are not aware about painful periods. But for women it is an important problem; because when they have their periods they can get a lot of pain in the abdomen. In that case, you should puncture these points; they're called the sacral points. The energy of the Bladder reaches this point and sends small branches inwards, towards the uterus, from the left to the right. the energy goes through these holes, there are branches toward the right-hand side of the uterus. In other words, the uterus is the point where energetic vessels cross, and what is admirable about what western medicine says, the western medicine speaks about the sacral plexus, and this plexus innervates or irrigates the uterus--and in oriental medicine it's the same thing--but when western medicine speaks about the sacral plexus, it doesn't have a method of curing the pain, whereas in our case as soon as you talk about the theory we have a clinical example. That means that the word 'theory' in occidental and oriental medicines has a completely different meaning. In western medicine, theory means something which you establish from something unknown, and from there to clinical experimentation; and in oriental medicine, theory is the opposite: the clinical results are what makes the theory in oriental medicine, it has to come from clinical results. This is why in western medicine when you talk about medical theory, it changes every six months, whereas in oriental medicine the theories stay the same for thousands of years. I said two thousand years, but actually [it is] since the creation of man. I've been talking about the Bladder channel. In the case of pain you have to puncture one of these points. It would be better to puncture Bl-32 because the opening is larger than that of the other points; however, here's an example: if you meet a woman of 40 or 45, [and] she frequently presents signs of rheumatism, and in western medicine there is a phenomenon of 'sacralization', which means all these openings [the sacral foramina] begin to close up; how can you puncture them if they're closed up? When you have the phenomena of sacralization, which means that there's a calcium deposit which is deposited there. However, these openings are where the nervous and vascular vessels enter and leave, and veins. So only a small hole is left, a little hole, , or it might be there, or there. So how can you puncture it? You have to put in the needle, first straight, there's a sort of a , you'll feel a resistance, but you'll feel a
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resistance when you reach the calcium deposit, you have to turn, incline the needle and you try to find the place where you can put your needle in further. If you're dealing with a young girl of eighteen, for example, with dysmenorrhea, which is pain during the period, it's very simple, you would just needle straight. When you put the needle in you have to put the needle right into the interior, at least 2 cm, and you turn it. If you manipulate your needle well, the patient will feel a sensation of coolness or freshness in the affected area. I've been trying to explain or to show you that chinese medical theory is established from that which is known: because the Bladder means the Tai Yang, which also means 'the channel which brings water'; Kidney corresponds to water; the Bladder also corresponds to water. So you manipulate the needle with the idea of bringing the water from the Bladder channel into the affected area. I've given you a broad description of the genitourinary apparatus. But you know, women are not like men, they have a lot of problems, especially psychological or mental types of problems, family problems, problems with children, their husbands, therefore there is often a lot of disturbance or worry on a mental level. When there is a worry or disturbance psychologically, energetic circulation is frequently obstructed. In this case there is stagnation of energy or blood at the level of the genital system, which is where the pain and inflammation occur. Food, or diet, plays a very important role. [I think] that in the United States there is less dysmenorrhea than in Europe because I see how the American people eat, I've noticed that in the fifteen days since I've been here. They eat a lot of salad, not much of meat, lot of tea, in other words, it's a semi-vegetarian diet, almost. In Europe, there is a lot of salt on the dishes, a lot of spices, the food is, the diet is stronger, richer, the women of these countries have more heat, heat that comes from the diet, which can reach the genital area to cause genital problems. But unfortunately, Americans like to exercise and do sport, and they ignore, they don't pay attention to temperature. In this case, if they do a lot of sports in damp weather, for example, the humidity can penetrate into the genital area, and it causes a syndrome known as damp-cold, or cold-damp. And the prolonged stagnation of cold-damp in the vagina transforms into damp heat. This damp heat can burn the vaginal tissue and then you have salpingitis, endometritis, cervicitis, etc. So you can see that the climate also plays a very important role in female problems. There are also women who overdo sexuality, too much sex. In this case they have the result of an exhaustion of Kidney energy, because I just showed you how the Kidney is the Source of the genital area. When the Kidney is deficient, energetically speaking, the Ren Mai and the Chong Mai don't function properly, and then the Kidneys will cause problems in the other organs, and this can provoke a syndrome called a deficiency of
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blood and energy in the genital apparatus; and this is when we find syndromes such as amenorrhea and oligomenorrhea. This damp heat of external origin can establish or localize itself in the uterine wall and it will not, it may not transform into heat, it transforms into phlegm (the word mucus in the western sense of the word is something which is secreted by the organs, whereas the word phlegm means that there is a materialization of humidity). Cold-humidity, when it stagnates for a long time, turns into drops of a substance; this substance, when it is in the uterine muscle, develops, gets bigger, increases in size and we call it fibroma. But when we talk about fibroma in western medicine, there are uterine fibromatosis and fibroma. In the case of fibromatosis it also always entails metrorrhagia. In this case, the disease is more serious, whereas in the case of small fibroma acupuncture can treat this condition. But if the fibroma is the size of a head, then you have to operate. We're not going to exaggerate what we can do. When there is too much heat in the uterus, this heat damages or interferes with the blood; we say in western medicine that the heat dilates the vessels and can burst vessels, which is where hemorrhage comes from. In gynaecology, when we use the word hemorrhage, we have to be careful; women have periods which prolong for a long time, they might last twenty days, every month she may be unwell for twenty days. We call that prolonged periods. We Americans have one word to describe this illness, we describe this as a case of menometrorrhagia--and that we can treat. In the case of real uterine hemorrhage, you mustn't insist on treating it, you mustn't keep this client, you must send her to a specialist, because this kind of hemorrhage is often of cancer, origin of cancer, or it comes from another very serious illness. Even in western medicine there are limits, because now I am a western gynaecologist; if this patient comes with a hemorrhage, I will examine, and I will establish that there are some doubts, I won't keep this patient, because this could be of a cancerous nature. I would immediately send her to a surgeon specializing in obstetrics to do a complete examination. This way of treating fits in with the way of thinking of both types of medicine. Because we are in the United States. Because we must always consider the similarities of the two medicines, the equivalences. ---morning break--
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(Dr. Van Nghi continues) Now that we have studied the pathology, we're going to start with the easiest of the diseases--dysmenorrhea; and then I will describe how a disease presents itself to you, because often when you read the chinese texts it's confusing, it seems that it's best to describe a disease often in the western fashion. First, definition of the medical term, next the physiopathogenesis, that is the study of the cause of the disease, and then, of course a disease has one name but it may have several forms. Western medicine nowadays seems to treat the name and not the cause, which means they give the same treatment, whether it's form A or form B. As an example, if I had rheumatism, they give cortisone; in Chinese Medicine you have to distinguish: which type of rheumatism is it? This is very important. And then there is the study of what is called nosology, which is the detailed study of symptoms, because each form presents completely different clinical symptoms. And we use the clinical symptoms as the basis for choosing the points. And finally, there is the application of therapeutics. Now I'm going to give you a little example of the disease known as dysmenorrhea. We have to define this term: it's a painful state of the abdomen, before and during the menstrual period. The intensity of the pain varies greatly according to the individual; occasionally the pain forces the woman to stay in bed, in another words she cannot carry out her daily activities; that is the word dysmenorrhea. Now the causes, the physiopathogenesis. Study of the causes: roughly speaking, in Chinese Medicine a disease may present itself in different forms, either excess or deficiency. In case of an excess, it can be of exogenous origin, for example being subject to a lot of external climatological influences for a long time, which means that the cosmic perverse energy can penetrate into the organism, into the body, and cause disease, and this is what we describe as an exogenous cause, coming from the exterior. But dysmenorrhea can be caused by problems with the diet, irregular diet. So excess is of exogenous origin--perverse energy--or diet. Eating too much cold food can cause a slowing down of the circulation of blood and energy in the uterus, because cold slows down activity, and when there is heat, there is greater activity. In these two cases, there is stagnation of blood in the uterus, and this causes pain. The excess condition can also be caused by psychological or emotional disorders cause it. As I said this morning, family problems, economical-financial problems, which cause psychological distress can also cause a blockage of energy and blood at the level of the uterus. These three phenomena cause the phenomenon known as stagnation. Now, deficiency: deficiency is often due to a deficiency of blood and energy. For example, in the case of post-partum hemorrhage, in the case of convalesence after a long, serious illness, in both these cases there is always a deficiency of blood and energy. The uterus is in an undernourished condition. Repeated sexual activity may also disturb the
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Kidneys, in other words also the uterus, and can provoke signs of deficiency in the uterus, causing pain . I've very roughly given you a way of distinguishing two types of dysmenorrhea in Chinese Medicine: excess or fullness, and also deficiency dysmenorrhea. In excess dysmenorrhea, to treat it, you have to look for the cause. For example, if it's caused by perverse energy, you have to destroy the perverse energy by applying sedation technique, or dispersion technique. If it's of a dietary origin, you have to regularize the Spleen and Stomach system. If it's psychoaffective, in other words psychological-emotional origin, you have to wake up the Shen, in other words harmonize the mind and spirit. In the case of deficiency, we are considering the case of undernourishment of the uterus and you have to treat blood and energy. To treat the blood, there are organs which regulate and regularize the production of blood. The organs which regularize and regulate the production of blood are the following: the Liver--the Liver conserves the blood volume; the Spleen spreads the blood; the Kidneys make blood. The Chinese say that the three Yin produce, circulate--produce the volume of blood and make it circulate, and then keep it in balance. Among these organs the Spleen plays a very important role. This morning I explained that the Spleen corresponds to the Earth [phase], corresponds to humidity, it's the place which is the source of all the transformations of the body. And there are specific points which you need to learn by heart. For example, Sp-10, Xue Hai, 'Sea of Blood'; it's a classical point which everyone knows. In the case of blood deficiency you should always use this point. But in both ancient and modern texts they propose that this point should always be associated with Bl-17, which is the shu point of the diaphragm. I, myself, have an American type of mind, and I have accepted that point [Sp10] because it has the name Xue Hai, whereas that point [Bl-17] has no connection with the blood. You have to prove this to me, if I have an American way of thinking. So I'm going to demonstrate it to you. Once you've learned about this point you will never forget it. Bl-17 is the shu point of the diaphragm. What is the diaphrgam? It's a muscle which causes continuous movement. You know that in front of the diaphragm there is descending energy and another energy which ascends, in other words the energy of the Stomach and of the Spleen. The movement of the diaphragm causes the energy to descend and ascend. And in Chinese Medicine, this is an innate movement. Dr. Tran will explain to you in more detail the embrylogy of this movement. For the rest of us, we all know that we have a diaphragm which never stays still, it constantly moves up and down. This movement regulates the circulation of the Spleen and the Stomach. This constant movement of the diaphragm causes movement in this area, and we know that the fundus, that is the center, one of the burners, the middle burner, in occidental terminology it is the fundus; when food arrives at the level of the fundus, the phenomenon of digestion 13
occurs, which is more exactly a phenomenon of alimentary metabolism. This phenomenon of metabolism gives off energy and blood. This is why Bl-17 has the important property of accelerating the movement of the stomach in order to accelerate the production of blood and energy. In the case of a blood deficiency, therefore, you have to needle Sp-10 and Bl-17. Now you know why the ancient and modern texts talk about Bl-17, but [they] didn't explain why--now you know why. Since we're talking about the cause of the disease we have to talk about symptomatology: in the case of a dysmenorrhea of excess origin, the pain arrives before and during the period, and this pain is exacerbated, made worse, by palpation. On the other hand, in the case of deficiency, the pain is improved by palpation. This is why in the case of the woman you have to know how to palpate the abdomen. And the reason for doing the palpation is to study deficiency and excess. And I know that you're going to ask me, well what about the pulse? The pulse represents the control of clinical signs and also [of] what the patient tells you. For example, supposing [she] came along with dysmenorrhea of excess origin, because when [I palpate] the abdomen there is pain, [I] would look at [her] complexion, and [I] would notice that [her] complexion is nice and pink and normal, she's slightly thirsty; [I look] at the tongue, it's slightly yellowish, yellowish tongue is the sign of the presence of heat. In this case you would expect there would be a rapid pulse, and tense, tight. But in the case of deficiency, the tongue is pale, there would be a whitish moss, the woman feels quite good when you touch her stomach, it doesn't cause her problems; in this case I would check my findings according to the pulse--because in the case of deficiency the pulse would be deficient. In other words, to treat the disease it's fine to take the pulse, but you must first examine the clinical symptoms: the complexion, the tongue, etc., the pulse is actually secondary. Later on, when you've become a great acupuncturist, you have to study the pulse, but for now, with the clinical signs, and the examination of the complexion, and abdominal palpation: that is actually enough for gynaecology. And again, in the case of dysmenorrhea from excess, the blood is red and there is a possibility that there will be clots; and there is a sensation of relief after these clots are evacuated from the uterus. These are the signs of dysmenorrhea of excess origin. Now dysmenorrhea from deficiency. The patient always presents with signs of nausea and vomiting. In another words, there is an enormous difference between deficiency and excess: in the case of dysmenorrhea of excess origin, [there is] no nausea or vomiting, whereas if the patient presents with pain and nausea you know it's deficiency. The blood is pale, there are no clots, and when you palpate the abdomen the patient has no discomfort, and the pulse is weak. You have to know how to distinguish the two types of dysmenorrhea.
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Now, how to treat it. In the case of the excess type, you have to encourage the circulation of blood and energy. I explained a moment ago that in the case of excess there is the phenomenon of stagnation; where there is stagnation there is pain. Our most important duty as doctors is to fight the pain. We're talking about the pain of gynaecology. This morning I already told you a point, Bl-32--so you have to puncture this point, it's very important. In dysmenorrhea, the specific point is Bl-32, and this is the way that you make blood and energy circulate. In the case of deficiency, should you employ acupuncture or moxibustion? Personally, I would propose moxibustion, but since we're in the United States, if a woman comes to you to be needled, you use little needles and you pretend to needle. And the real treatment, five or ten minutes afterwards, is moxibustion. The chinese say that in the case of deficiency you have to warm the point, warm up the circulation of the Ren Mai and the Chong Mai, to activate the production of blood and energy of the Kidneys. A while ago I told you that the Kidney plays an important role in the formation of blood. That's the Chinese term, which means that the energy of the Kidneys can produce blood. Now we're coming back to the United States--the marrow produces blood. The Kidney rules the marrow: so you see, the ideas are the same. In other words, western medicine says that marrow produces blood, but they don't know how to activate or tonify the marrow. But we know: you have to tonify the Kidneys because the Kidney sends its Jing to the marrow to support and nourish it. This is why in my opinion the ideas of the two systems of medicine are exactly the same. If you have a good grasp of western medicine, you can prove all of the chinese ideas. Another example: the chinese say 'the Liver is a general'. I'm an american person--what are they talking about, 'the Liver is a general'? ( i.e., the military officer ) What does that mean? In western medicine, they say the Liver plays an important role in the defense of the organism. For me, it's the same thing. Because the one is a general of an army, and the other is defense--it's the same thing: the chinese are talking about one thing, the western medical people are talking about another thing, but it's the same meaning. Before treating dysmenorrhea, we have to choose specific points, before treating the form, or the type, of the disease. I told you before that the specific point is Bl-32, and I said that you have to regulate the blood and energy, and in order to regulate blood and energy you have to choose a point whose branches go to the uterus. I explained that this morning: this point, which is CV-3. Then, there is another specific point, Sp-6, because the three Yin, as I said a moment ago, produce blood. the channel of the Liver, the Kidney, the Spleen. They join at that point. If you tonify this point, it's to harmonize and regulate the blood. Sp-6 is a specific point in all gynaecological disorders. Bl-32 is a point to treat the pain of all gynaecological disorders. And CV-3 means 'the uterus'. So these are the three points you should use first.
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In the case of stagnation--in the case of perverse energy, in the case of dietary problems, and in the case of emotional problems--you're obliged to dissolve this stagnation. In oriental medicine we have specific points in each case where there is a blockage or stagnation, which are the Xi-cleft points. I have to puncture Sp-8; Sp-8 is a Xi-cleft point. I explained a moment ago that the Spleen plays an important role in moisturizing the apparatus of the woman and also in the mutation [transformations in the organism]. If you puncture the Xi point, which is Sp-8, it's to dissolve and unblock the stagnation. And then you have to regularize the blood, which is [done by means of] Sp-10, and to regulate the energy, which is [done by means of] CV-6. These are the points you use, then, in the case of perverse energy, or in the case of dietary dysfunction, or psychoaffective disorders. You puncture those points first, and in the case of stagnation you add the following three points. Now, in the case of deficiency, which is actually a lack of blood, you have to activate the production of blood in the uterus. The two classical points are CV-4 and St-36. St-36: when you tonify this point you activate the production of blood and energy in general. When you add the point CV-4, what you're doing is taking this increased blood and energy and making sure that it reaches the uterus. These are classical formulas. In Chinese Medicine, a classical formula is a type of formula reserved for students. But we acupuncturists of a long time, we respect those three points [ ] but we don't respect the other one [ ]. For example, in the case of psychological-emotional disorders, we would also have to add points having an anti-depressive effect, which are: GV-20, Yintang (Curious point #3), CV-17, and He-7. If the problem is of dietary origin I wouldn't use those points, I'd use Bl-20, Sp-3, Bl-21, and St-42, which means that I needle the Backshu point of the Spleen, the Source [Yuan] point of the Spleen, the Source [Yuan] point of theStomach, [and] the Back Shu point of the Stomach, with the idea of regulating the Spleen-Stomach system. In the case of a deficiency of blood, I must always add CV-12, Li13, and St-36. These three points are enough to activate the formation of blood and energy. This means that the formula in Chinese Medicine is not rigid, everything depends on the knowledge of each one of us. But the most important thing is to know the specific points for each disease. For example: in gynaecology, Sp-6; in opthalmology, GB-37; in central nervous system diseases, GB-39, etc. This is very important. This is where you add points to the classical formulas. I've just dealt with dysmenorrhea. We have another half-hour, we can talk about another gynaecological disease. We're going to talk about the easiest diseases: irregular menstrual periods. You know that in the West, especially in the United States, when we use the term 'irregular period' we either mean a short cycle, a long cycle, or an irregular cycle. Now in the case of a short cycle, there is bleeding before there should be, the blood arrives before it should; now we are traditional acupuncturists, we must of necessity ask 'why?'. This is extremely important. We know that heat accelerates the blood--in other 16
words a short menstrual cycle is caused by yang, by heat. Now the long cycle--we have to ask: why does the blood arrive late, after when it should arrive? Because the lady in question has a problem with cold. And this cold or this heat is from the Kidneys, caused by the Kidneys, from the Source. We know that cold retards all human activities, and the cold contracts [while] the heat dilates. And the blood vessels of the uterus contract when the female patient has signs of cold. In western medicine they're always talking about irregular cycles, we also have to ask why is this, what is this about? This means that in the body of this woman the cold and the heat are in a state of disorder: now there is too much cold, now there is too much heat. And all these signs are seen in the change of character of this woman: she'll have good moods and bad moods, she may be very nervous. In which case we have to regulate her Yin and Yang. Where do we find her Yin and Yang? In the Kidneys. But you have to know one or two clinical signs. In the short menstrual cycle, she might have her periods twice in one month, whereas in a long cycle the menstrual periods arrive always between ten and twenty days after the date when they're supposed to arrive. Since we're gynaecologists, we have to ask her about this, what the blood is like [in] color. In the case of a short cycle, the periods are heavy, because there is heat, and the color is red because there is fire; in the long cycle, the color of the blood is pale pink. (In order to earn your forty dollars, or twenty-five dollars, you should ask about the pulse, etc..., and the color of the eyes.) In the case of the short cycle, women often have bloodshot eyes.
When you puncture these two points, you regulate the circulatory system with fire. Because in the case of dysmenorrhea, there is always more or less fire, more or less Yang. So when you puncture these points it is to regulate the circulatory system of blood and energy, of Yin and Yang. Those are specific points that you have to know. Now in the case of the short menstrual cycle, where there is fire, you have to put out the fire. You must not put out the fire of the body, because it is your essential energy. You have to slow down the circulation or put it out. And we put it out with Earth points, in other words, Li-3--the Liver governs the genital system--the Yuan point of the Liver, in other words the humidity of the Liver, the Earth point; you use it in the case where there is too much Yang, too much fire. The long cycle is called a cold cycle, energetically speaking. In this case you have to heat up. Where should you heat up? You heat the Yang Ming, in other words St-25 and St29. St-25 is the front mu point of the Large Intestine, of the Yang Ming; St-29 has the name Guilai, which means 'making things come back'. The Yang Ming corresponds to dryness; if you puncture these points you cause a little fire, which penetrates into the uterus to fight cold. This is the technique you will find in all the chinese books. I don't use it like that. But it does give just as good results. There are two ways to do it: you know that the Liver controls or commands the genital system, so we have to tonify the heat point, the fire point of the Liver to combat the cold in the genital area; in other words, Li-2. Why Li-2? Because it's the Yung [-spring] point, which is the second antique point, corresponds to heat. Li-2 is the sedation point; if I puncture this point and sedate it what it means is that I remove the heat . For example, in certain cases of hepatic diseases, such as viral hepatitis, which causes fever, this fever is nothing more than the exhalation of ministerial fire. This is why I have to sedate Li-2: because there are microbes, and the heat is caused by these microbes. But now if I want to produce this heat I tonify Li-2. Because in the case of the long cycle there is a lack of heat, I have to produce heat, and so I have to tonify. In conclusion, all acupuncture points can be tonified or dispersed; everything depends on context, everything depends on the clinical form; you mustn't think that a tonification point always has to be tonified. When you talk about tonification or sedation points, it is to remove or give back energy at the level of the meridians. But perverse energy: is it found in the principal meridians or elsewhere? Now, because we are americans, we have to know exactly what the answer is. In principal, if perverse energy is in the principal meridians it automatically causes problems in the organs and bowels and it means the disease is extremely serious. Fortunately, we have the defensive energy, which stops this aggression. Therefore in the majority of cases the perverse energy is found in the secondary vessels. This is a very important idea. If I have periostitis of the shoulder, for example, I would say I have a pain here; you would say 'it is your Large Intestine channel which is at fault'; no, it's not that, it's the secondary channel of the
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Large Intestine. This is very important. We use the technique of the tendinomuscular meridians. I've got five minutes left, I'm going to give you this technique, and you'll be able to cure all diseases of external origin. [Here is the shoulder. Here is the pain--ths patient shows you that.] I have to sedate this painful point. I insert the needle and disperse. How do I put it in? That's a secret--the Grand Masters know it but don't tell you. In order to puncture these points in the shoulder you have to puncture obliquely, in subcutaneous manner. And put it in at least 2 or 3 cm. In other words, subcutaneous needling. And then you have to find which principal channel circulates through this area. Suppose it's the Large Intestine: you have to tonify the Large Intestine principal channel. In other words, you puncture LI-11 and you reinforce the action of this point by using LI-4, the Source point, Yuan point. It's enough to cure the pain. But our chinese colleagues have not yet determined the different systems of meridians. We have the tendinomuscular system, the Luo system, Longitudinal Luo system, curious meridians, distinct meridians: there are six or seven groups of meridians that you have to know, and they now evidently only teach you the principal meridians and the points. This is only really a very small part of acupuncture. In the end, you can't treat the pain. I've got a toothache, I have to ask my teacher how to treat, we have to open the book to find out how to do it. But there is a technique. In all the cases of pain, you disperse the painful point and tonify, not disperse, the principal channel. This is extremely important, because our chinese colleagues don't yet know this. After lunch, Dr. Tran is going to talk about San Jiao energetics and the formation of energy. If you leave me a few minutes, I will finish what I was saying, because it's too long. (--Lunch break--)
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Dr. Sean Marshall: Our next speaker is Dr. Tran Viet Dzung, whom I recently met this spring in Connecticut. He has been a long-time collaborator with Dr. Van Nghi; in fact, he told me that he met Dr. Van Nghi about fifteen years ago -- and he hasn't slept since. Dr. Tran Viet Dzung...
Dr. Tran Viet Dzung Hello. Thank you for coming. We're going to begin first of all straight away with the formation of energy. You know that acupuncture is a technique of oriental medicine. And you know that oriental medicine is a medicine of energy. And everyone knows that. We have had the occasion to not only visit the United States but also other countries of the world quite often, and we have established the following: that lots of acupuncturists know that they have to practice a medicine of energy. But when you talk about what energy, they're not exactly sure. When you talk about the formation of energy, they can't tell you exactly how this energy is formed. This is why what I'm going to tell you is important as a basis of acupuncture. And in talking about the formation of the different types of energy I have to talk to you about the San Jiao. You know that the San Jiao is something extremely important. It's so important that I'm going to tell you a story: you know that in the eleventh century in China, there was an emperor; you know that at that time chinese emperors were well known for being very erudite, not only in poetry and music but also medicine. One day he heard talk of a chinese doctor who only treated people by means of the San Jiao. He sent for this doctor to come to his court, and he asked him: 'Why --in the human organism, you have the meridians, you've got the muscles, the bones, the organs and bowels--how can you say that you treat everything by means of the San Jiao?' The doctor answered him: 'This is such a difficult and important subject that I can only tell somebody who has sufficient knowledge of the subject.' The emperor, crazy with rage, had him beheaded. And since this, the generations of the doctors who came afterwards always get together to study the idea of the San Jiao. Everything I'm going to tell you is found in the Nei Ching, especially in the Da Cheng ("Art and Practice of Acupuncture"). But as you already know, in the ancient texts, whether it is the Nei Ching or the Da Cheng,when they talk about ideas, they talk about one idea in book one, another one in book five, and then the third one they come back to in book three. So they never give you a synthesized, or global, idea of the whole thing. I'm going to try to do a synthesis of all these ancient books and to try to give you a complete idea of the San Jiao.
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You've noticed that I've been using the word 'San Jiao'. You've never heard me speak of the 'Triple Heater'. Because for us this word means nothing. 'San ' means 'three'. 'Jiao' means 'metabolism'. In other words, the function of the San Jiao is the function of the division into three metabolisms. These three metabolisms are: metabolism of energy, metabolism of blood, and metabolism of organic liquid. Today we're going to speak about energy. I'm going to present several ideas: I'm going to talk about the formation of Ying energy. As you know it's also called Nutritive, or nourishing, energy. I'm going to talk about the formation of Jing energy, which you know is the energetic quintessence. I'm going to also talk about Wei energy, which is very important here in the United States because it concerns allergy a lot; it's the defensive energy of the body. And then I'm going to talk of the energy Tong Qi, which we could regard as Ancestral energy. And then to conclude everything, I'm going to explain how to treat by using the San Jiao. First, Ying energy. This is the anatomy described in western medical terminology. As you know, in Chinese Medicine the cardia is the upper Jiao, the fundus is the middle Jiao, and the pylorus is the lower Jiao. And the three 'burners' together make the San Jiao. We prefer to use the term San Jiao, and if you really want to use the term in a western way, it would be better to call it 'triple metabolism', for the reasons I described earlier. And since in the west, whether it is in Europe or in the States, we have the habit of calling it the 'triple heater', [I'm] going to continue to use that term, but you should understand that that is a term which has been badly translated. Why? Because all the ideas about the San Jiao show that it is concerned with the metabolism of water; when you talk about 'triple heater' it has an idea of heat, or Yang, which doesn't mean anything. You know that man is between Heaven and Earth. We're only alive because of the food we eat and the air we breathe. the food, it comes into the digestive tube and reaches the fundus. When it reaches the fundus, what arises is a phenomenon of metabolism. This gives off an energy, as a result of this metabolism, which in western medicine we call calories, but which we call the energy of the cereals, energy of the grains, because it comes from food, and the food comes from cereals, cereals come from the earth. This energy which is produced from the cereals--where does it go? It goes to the Spleen. Why to the Spleen? Because you know that the Spleen and Stomach are the Yin Yang system. So this energy of the cereals goes to the Spleen. Once it has arrived at the Spleen, the Spleen send this energy to the Lungs. Why? Because the Spleen and the Lung are in a mother-son relationship [Earth creates Metal]. The Lungs are the child of the Spleen. So the energy of the cereals which reaches the Spleen reaches the Lungs. Also the energy of the Spleen and the Lungs together is Tai Yin; they both have the same energetic level: the Spleen is the Tai Yin of the foot, and the Lungs are the Tai Yin of the hand. When this energy of the cereals, or if you prefer, energy of the Earth, reaches the Lungs, the Lungs have two roles: the first role is the absorption 21
of the Earth energy coming from the Spleen, and the other role is the absorption of the Celestial energy coming from the heavens, or the sky; in other words, oxygen. The energy of the sky is Yang, whereas the energy of the Earth is Yin. When, in the Lungs, Yin and Yang meet, the Ying energy is formed. It's Nutritive Energy. This energy goes to the superior part of the thorax, and emerges at the point which you all know, which is Lu-1. Then it goes into the Lung channel, Large Intestine, Stomach, Spleen, etc., as far as the Liver channel, at which point it returns to the Lung. This is following the cycle known as the circadian cycle of 24 hours. That is, that the energy circulates in the Lungs from 3 to 5 am, 5 to 7 in the Large Intestine, etc., and returns to the Lungs from 3 to 5 am once more. This is the circulation of the Ying energy, Nutritive energy. This is why--open any book of acupuncture, in any country, you will see that they always teach you first about the channel of the Lungs, and then this pathway, always finishing by the Liver. This is in agreement with the circadian cycle of Ying energy. That's roughly what you need to know about the formation and circulation of Ying energy. We're now going to discuss Jing energy. As I said, Ying energy circulates in the principal meridians and it then goes into the organs, and then it comes back into the meridians, then it reaches one of the bowels, then it goes into a channel, into an organ, etc. <--illus.--> This is the circulation of the Ying energy. First it goes to the organ of the Lungs, then into the Large Intestine, then Stomach (following the cycle of Ying energy which we just talked about), then into the Spleen organ, then into the Heart--we're continuing according to the circulation of the Ying energy--then into Small Intestine, Bladder, and it reaches the Kidneys, then it reaches the Pericardium, then the San Jiao, Gall Bladder, and terminates at the Liver. You know that Dr. Van Nghi this morning told you that as far as the bowels are concerned, they form a function of transit, that is, Ying energy arrives and then leaves. But what is extremely important is what happens in the organs. Because what happens in the organs is a phenomenon of metabolism-metabolism of what? There is metabolism of Ying, that is Nutritive, energy which is transformed into an even more pure form known as Jing. You may have heard several times that the Lung rules the nose, for example. What is it about the Lung, what does the Lung have to rule the nose? What energy? It's not the Ying energy, it's Jing, Jing which is formed in the Lungs as a result of the metabolism of Ying energy; in other words, the Ying energy arrives in the Lung organ, when it arrives in the Lung, if the Lung is in a period of normal activity, when it's functioning normally, not hypoactive, what is its role? It is to metabolize the Ying energy into Jing, Jing of the Lungs. And it is this Jing of the Lungs which goes to govern the skin and the body hair. It is this Jing of the Lungs which governs the nose, and it is this Jing of the Lungs which allows us to have a sense of smell. This means that when you have a problem with your sense of smell, when you have a problem in the skin, you have to tonify the Lung energy-- but the Jing energy of the Lung.
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So the Ying energy arrives at the Lungs, is transformed and metabolized into Jing, it governs these functions, and then it continues: it passes by the Stomach, and arrives at the Spleen, which is an organ. Since it's an organ it's going to metabolize the Ying, into a more pure substance, which we call the Jing of the Spleen . And it's the Jing of the Spleen which rules the dermis (don't forget that the Jing of the Lungs rules the epidermis); it governs the lips, and the sense of taste. That is why you often have patients who come to see you with problems of anosmia, which means they are unable to smell different odors; but often there are patients who come to see us with both a loss of the sense of smell and loss of the sense of taste. So often it is very hard to treat these patients. But if you don't even know where to treat them you are never going to be able to completely cure them. This is why you have to treat the Jing of the Spleen--not the Ying of the Spleen. I'm going to tell you how to do these treatments, but for the moment we're just talking about physiology. We're going to continue. The Ying energy arrives at the Heart organ. The Heart is an organ; its function is to metabolize the Ying energy into Jing, the Jing of the Heart. And it's the Jing of the Heart which rules the blood vessels, the tongue, and speech. This is why often you have patients who come with speech problems; here again you have to treat the Jing of the Heart, if you really want the result to last. The Ying energy continues, and it goes past the Small Intestine, past the Bladder, because these are bowels not organs, and it reaches the Kidney organ. Again, in the Kidney organ there is metabolism of the Ying energy, transformed into Kidney Jing, which governs the bones, the marrow, and the brain. And it's the Jing of the Kidneys which governs the ears and hearing. This is why if you have a problem of deafness you have to treat the Jing of the Kidneys. The Pericardium is the same as the Heart. So the Ying energy continues and it passes by the San Jiao, and the Gall Bladder, and arrives at the Liver: once again there is a transformation, into Jing of the Liver, and it is the Jing of the Liver which governs the neuromuscular system; it's the Jing of the Liver which rules the eyes; and it's the Jing of the Liver which enables us to see, vision. So when you have an eye problem, a problem with vision, eyesight: for example when someone comes to you with the problem like a cataract, you know that all cataracts are often operated on, but you know that cataracts, if they haven't reached the point where they absolutely have to be operated on, you can get excellent results with acupuncture. You will not only help the patients avoid surgical intervention, but you will also help to put the disease into reverse. So now you know a little about how Ying energy is turned into Jing energy, and how the Jing rules the different systems. Where do we treat this Jing? You know that the Bladder channel has two branches: a medial branch and a lateral branch. On the medial branch you have all the shu points of all the different organs on the back, and on
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the lateral branch you have the points of concentration of the different types of Jing I am describing. For example, we were talking about the Jing of the Lungs. You know that on the medial branch of the Bladder there is a point Bl-13, which is the shu point of the Lung; on the same horizontal line, laterally, you have the point which is correspondent to the Jing of the Lungs, which is Bl-42. So that when you want to treat the Jing of the Lungs, this is where you have to work. We will continue with the Spleen: you know that the back shu point of the Spleen is Bl-20; on the same horizontal line but on the lateral branch [is the point of concentration of the Spleen Jing], Bl-49. We come to the Jing of the Heart: where do we treat it? The back shu point of the Heart is Bl-15; and the point of concentration of Heart Jing is on the same horizontal line as Bl-15, but on the lateral branch: Bl-44. We continue some more and we reach the Jing of the Kidneys: and as you know, the point of concentration of the Kidney Jing is on the same horizontal line as the back shu point of the Kidneys (which is Bl-23): Bl-52. In the case of the Liver, the back shu point is Bl-18, and the point for treating the Jing of the Liver is Bl-47. Each time that you want to treat the Jing of an organ you have to treat at these points which are on the lateral branch of the Bladder. This is very important, because in the West, especially here in the States, you have a lot of deficiencies, you have a lot of diseases such as diabetes, obesity, and you know that acupuncture can help these, or cure these types of illnesses. You have to treat the Jing. But we're not finished yet. I've been talking to you about Jing. And I'm still talking about Jing. But what I've been describing is the material Jing, the Jing which governs the different parts of the body: the epidermis, the dermis, etc. But there is also a non-material part: you know that when you talk about the mental, you might say 'shen'. This is another term we don't like very much. I've been working with Dr. Van Nghi for at least fifteen years and you know that he can share his knowledge with you--his mission is to develop oriental medicine, and to help the advancement of this science, and he has always said this to me: if you want to develop acupuncture, if you want to make it grow and spread, you have to be very strict in the way that you learn things, rigorous or strict in the way that we learn the words. Because if we employ words which are not accurate, we are not going to learn anything. Because in Chinese Medicine, every single word has a deep meaning, and if we don't use them correctly, we may end up making errors. And if there are errors in comprehension we cannot help our patients, we cannot get results. And a medical science where there are no results is a science that has no future. That is why we are very strict about the terminology. Take the example of the term 'Shen': ask any Vietnamese, Chinese or Asian person, they very rarely use the word Shen, they say 'Chen' in Vietnamese; in chinese they say 'Jing-shen', which means 'the quintessence of Shen'. So when we speak about Shen we're talking about the quintessence--this is why I'm going to talk about 'Jing-Shen'. So now I'm going to talk about the immaterial, non-material part of Jing, because man does not only consist of anatomy, but we also have a non-material
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part, which is extremely important. So important that everywhere we go now people talk only of psychological, mental and psychosomatic diseases. I would now like to present an idea which is not known very well by many doctors of acupuncture--you've often heard the saying that too much anger injures the Liver; they say too much grief or sadness injures the Lungs; they say too much fear injures the Kidneys; they say that too much thought injures the Spleen; and that too much joy injures the Heart. This is not correct. How can we understand this? I have told you that in each organ there is metabolism of Ying energy, and transformation into Jing, and we see that this Jing can be material, but it can also be immaterial. What is immaterial? This means that the Ying energy is going to transform into a Jing-shen, which is specific to each organ: in the Lungs there will be the immaterial Jing of the Lungs, which we call 'Po'; at the Spleen there is material Jing of the Spleen but also immaterial Jing of the Spleen, which we call 'Yi'; in the Heart it's the same: there is transformation into immaterial Jing, which we call 'Shen'; and in the Kidneys the immaterial Jing we call 'Zhi'; in the Liver it's the same procedure, we will have the JingShen of the Liver, which we call the 'Hun'. All of these are the quintessence of immaterial energy which is contained in the organs, the Jing-Shen of the organs. Example: here is the Liver. I told you that in the Liver, the Liver keeps or conserves the Hun; the Hun in the west can be translated as 'soul', the 'vegetative soul', in other words, which means the possibility of creation'. In other words, the Hun of an architect is more developed than ours because he has a creative mind. The vegetative soul is creative. The Shen is the mental (Heart); in the Spleen there's the Yi, which you can translate by 'Thought' or 'Reflection', which means that the Spleen conserves the Yi, therefore it conserves the thoughts and reflections; in the Lungs there is conservation of the Po. What is the Po? It's the sensitive soul, which means that when you're faced with an occurrence you may be more or less sensitive than another person, according to the Po which is contained in your Lungs. In the Kidneys is the Zhi, the Will. Among the immaterial parts of the Jing of the Kidneys is the Will. So when you want to increase willpower you have to tonify the Kidneys. Everything I've just told you, whether it's the Hun or the Shen or the Yi or the Po or the Zhi, are normal feelings which exist in our organism, in our body. These are all things which exist in the normal state of our bodies, which we don't feel--why don't we feel them? Because there is a harmony between these different categories of psychic or mental activity within us. We only recognize them when there is a pathological phenomenon. But in the normal physiological state--as I speak to you and you answer me--we are not aware of all these elements, because everything is in harmony. But if there is a dysharmony, this is when we feel--what are we going to feel? If I walked up to you and gave you a kick in the
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shins, what are you going to do? I would disturb your Hun. And this would provoke anger, you would feel angry. It's because I disturbed this person's Hun that there is anger. But it's not because there's too much anger that it damages the Liver. Does everybody grasp the nuance there? Anger is pathological , Hun is physiological. And the reason there is anger is because we have disturbed the Hun. But the Liver is not going to be hurt by anger. Same here: when the Shen is disturbed, you will have joy, but excessive joy. You will have problems with patients who laugh without knowing why, you will have emotion, and all of this is because you are disturbing the Shen. And it's the same for the Yi, thought and reflection--when you disturb the Yi, that is when you disturb the thought and reflection, what do you have? You have worry and anguish, anxiety. This [the Lung] is the same. When you disturb the normal physiological element, the Po, you will have sadness, You will find patients who are always sad and are always complaining. Why? because Lungs correspond to Metal, and Metal is the voice--so they complain all the time. The Will is a normal physiological component of our organism. When this Zhi is disturbed you get fear, extreme fear, paranoia even. And tears. In other words they are patients who are afraid and they cry all the time. These are what we call the seven psychological entities: anger, joy, worry, sadness, and fear; these are five. So why did I say seven? Because there is complaining or lamentation, and tears. And that's why they are described as the seven psychological elements. This a problem of Jing-Shen, regarded from the oriental medical perspective. To treat it: in the Nei Ching they say that you have to use the laws of the Five Phases (Wu Xing), according to the law of inhibition (Ko cycle). Occasionally you have patients who come to see you in your office, for whatever, but if they got stuck in a traffic jam on the way to your office they'll arrive in a state of anger. With the use of one single point you can treat their anger. So for whatever reason they're coming to see you, if they come presenting one of these emotions--joy, or fear, or whatever--you can treat them with one single point; and then at the end of the treatment you can ask them, 'well, what about your sadness or fear?' And they'll say, 'it's completely disappeared'. The Nei Ching talks about the cycle of inhibition. Here is the law of Five Phases: the Liver, Heart, Spleen, Lung and Kidney. I already explained to you that the Liver is associated with anger; and the Heart, joy; and the Spleen, worry or anxiety; and the Lung sadness; and the Kidney, fear. For example, if I want to treat anger, here is the law of inhibition: you know that this is Wood, this is Fire, this is Earth, this is Metal, this is Water. You know that Wood controls or inhibits Earth, Earth inhibits Water, Water inhibits Fire, Fire inhibits Metal, and Metal inhibits Wood. Anger is an abnormal feeling corresponding to Wood. If I want to diminish the anger I have to increase Metal, because Metal destroys Wood. So I have to find a point corresponding to Metal. Here is the principal channel. I gave you the example of anger, which also corresponds to Wood and
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to the Liver. So I'm going to use a point found on the Liver principal channel. Here is the principal channel of the Liver. You know that the principal channel of the Liver is Yin. And you know that from are the Su-Antique points: the Jing-well, Yung, Yu, Jing-river and Ho points. The Jing-well point of a Yin channel corresponds to Wood; the Yung point corresponds to Fire; the Yu point to Earth; the Jing-river point to Metal; and the Ho point to Water. I've just explained, I'm going to treat anger. I have to treat a point on the Liver channel, and on this Liver channel I have to treat a point corresponding to Metal. So which point will I choose? The Jing-river point, since that is the one that corresponds to Metal, and Metal controls Wood; and the Jing-river point of the Liver channel is Li-4. So in order to bring down a person's anger I would needle Li-4. We're going to take the example of joy. Joy is very nice; but excessive joy is a bit too much. So we're going to try to diminish it somewhat. How should we do this? What point would you puncture? To diminish joy, which point would you puncture? Water--the Ho point, He-3. Taking the example of anxiety or worry, which point? I explained that when you treat anxiety it's Earth, the Spleen. So you have to choose a point on the Spleen channel. Which point on the Spleen? The Jing-well point, Sp-1. Why? Because Sp-1 corresponds to Wood, and Wood controls Earth. Another example: sadness. What point? Lu-10. Because it's the Yung point, which is Fire. And Fire controls Metal. Fear: which point? Ki-3, because Ki-3 corresponds to Earth; we tonify the Earth to control the Water, the fear. Everything I've just told you is not just theory, not just 'blah-blah-blah'. Because we have used these techniques many, many times on our patients. But you have to be careful: what I've just told you here are little techniques, to treat minor psychological disturbances. I took the example earlier of somebody who comes to your office who is late; why? because they were stuck in a traffic jam; she comes to see you very excited and angry because she is late; you would puncture Li-4 in order to diminish this anger so that you can get on with your regular treatment. But in real, serious problems of psychological disturbance, such as those you find very frequently in the west, such as nervous breakdown and depression, we have to develop this reasoning a little further and treat the Shao Yin axis: the Kidneys and Heart. Because it is frequrently a problem of the separation of the Heart and Kidneys, separation between the Will power and the Mental, between Water and Fire. And you have to do the deepest type of treatment. But everything I've just described to you is excellent for treating minor psychological disturbances. Try it, and next time I come you'll be able to tell me your results.
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Saturday, 17 September afternoon session Now we're going to attack something of great importance, Wei energy. I was talking about Ying energy, and I talked about Jing: material Jing and immaterial Jing, in another words Jing-Shen. Now we're going to talk about Wei energy, which as you know is an energy of defense, or defensive energy. I'm first going to talk to you about the formation of Wei energy, and then I'm going to talk to you about the circulation of Wei energy. Formation of Wei energy [in English!]: Are you ready? Let's go! is the Stomach, the Upper Jiao, Middle Jiao, and Lower Jiao. is the cardia, here is the fundus, here is the pylorus. I told you a moment ago that food arrives at the fundus, and here there is the phenomenon of metabolism, and production or giving off of the energy of the cereals or the grains (Ge Qi), the terrestrial energy, which goes to the Lungs, where it combines with the energy of the air (Da Qi), which is celestial energy, and it forms Ying energy. But what remains here from food metabolism, where does it go? It goes to the pylorus , and here something happens which is called a phenomenon of decantation. What remains from the metabolisation of food, there is material and liquid; at this point there is a separation into material and liquid, and that is what we refer to as decantation. So at this level [the pylorus] there is the first decantation, the separation of the material and liquid for the first time. Where does it go? It goes to the Small Intestine: you have the pylorus [1st decantation] and the Small Intestine [2nd decantation]. At the Small Intestine, the same phenomenon: you have material element on one side and liquid on the other. But here you have more liquid than material, because it's the second decantation. And at the same time as this second decantation there is the first purification, of the liquid part: so there is a purer part of the liquid and an impure part. Where does the pure part go? It goes to the Kidneys. Why does it go to the Kidney? Because there are mesentery vessels which join the digestive tract to the Kidneys: it is called the mesentery system. And the impure part goes to the Large Intestine ; and here in the Large Intestine there is a third decantation: here there is the impure part which has come from the Small Intestine. And at the same time as the third decantation there is a second purification [ie, of the liquid portion]; at this point there is already the liquid part, which is again going to be separated into pure and impure. Where does the pure part go? Again, the pure part goes to the Kidneys, following the mesenteric system, and the impure part which results from the second purification rejoins the material part which remains here and is eliminated by the anus as stool, feces.
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That's it for decantations: the first decantation, the second decantation, the third decantation; but the purification goes on. In the Small Intestine we have the first purification; in the Large Intestine we have the second purification; the pure part goes to the Kidneys and the impure part follows the rest of the material part, and is eliminated in the stool. At the Kidney, the third purification: the pure part goes to the Liver . Why does it go to the Liver? Because the Liver is the son of the Kidney. The Kidney is the mother of the Liver. So the pure part goes to the Liver. The impure part goes to the Bladder, because the Kidneys and Bladder form a Yin-Yang system [of Water]; at the Bladder there is a fourth purification: the pure part goes to the Gall Bladder, because the Gall Bladder is the son of the Bladder, and the impure part is eliminated as urine. This is why at the Bladder there is a separation between what is pure and what is impure. It's the last stage of separation into pure and impure. That's why when you read in the ancient texts about the Bladder they always say that the Bladder is the 'customs official', the one who guards the frontier; because it keeps what is pure, and let's go through what is impure. At the Liver there is a fifth purification: the impure elements go to the Gall Bladder and associate with the pure part coming from the Bladder, forming bile; and since the Liver corresponds to the color green, you often see that bile is green. Once the bile has been formed, from the impure part coming from the Liver, and the pure part coming from the Bladder, where does it go? It rejoins the digestive tract at the Small Intestine, via the choliduct, to humidify or moisten the intestinal mucosa, of the Small and Large Intestines, with the aim of preventing constipation. This is why western medical doctors frequently prescribe bile pills to treat constipation. But they don't know why. And the energetic physiology of oriental medicine gives the reason why. At the Liver there is the fifth purification, as I said: the impure part goes to the Gall Bladder; where does the pure part go? When you prepare a medicine you make it go through several levels of tubing, and you heat it in one area [ie, process of distillation]; and at the end you obtain a product which is volatile, the active principle, which is very volatile: these are the phases of distillation. In the human organism you have the first stage of purification [at the Small Intestine], second stage of purification [at the Large Intestine], third stage of purification [at the Kidneys], and fourth stage [at the Bladder], fifth stage of purification [at the Liver]: it's exactly the same as if you were preparing a medicine: when it arrives at that point [ie, at the Liver] it's a vapor, it's vaporized, volatile. That's what happens here in the Liver. The impure part goes to the Gall Bladder, but the pure part is given off in the form of a vapor, which is the Wei Qi. This is why Wei energy is a very mobile energy: it's mobile because it's volatile. Why is it volatile and mobile? So that it can reach all the areas of the body quickly to defend the organism against external attacks or agression. This is why we call Wei Qi the defensive energy. And since Wei energy is formed in the Liver, as Dr. Van Nghi told you this morning, every time that you learn about the Liver they tell you it's a
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General; because that is where the defensive, Wei, energy is formed. It's like a general who leads his troops into combat; and even in western medicine they say about the Liver that it has the role of the defense of the organism. But western medicine only makes that statement, it doesn't explain why that is; whereas in Chinese Medicine they know it is because that is where the Wei Qi is formed, and that's why the Liver is called a general. I've just told you about the formation of Wei energy. Now we're going to talk about the circulation of Wei energy. I told you a while ago that Ying energy goes to the Lung, Large Intestine, Stomach, etc., arrives at the Liver, and starts the cycle all over again at the Lung, following a twenty-four hour cycle, the circadian cycle. The circulation of Wei energy is completely different: it follows a day-night cycle; Iwill explain: it follows the Liver channel and arrives at Li-14; from Li-14 it ascend towards the upper areas, crossing the neck and face, and arrives at the eye: to be precise, it arrives at the point GB-1. Let's think about the area of GB-1: here is the area of Tai Yang; this is GB-1, and the area of the Shao Yang, and below we have the area of Yang Ming. GB-1 is at the level of the Shao Yang; so the Wei energy, once it arrives at GB-1, in other words at the level of the Shao Yang, has a circulation which looks like this; in other words, it reaches the whole of the Yang area of the body. In the morning when you get up, as soon as you begin the movement of your eyelids, blinking, you immediately begin to make the Wei energy circulate, and it immediately answers and goes to the Yang areas of the body, the posterior parts, lateral, and then it reaches the Yin areas. That is how Wei energy circulates during the day. During the night the Wei energy concentrates itself at the Jing-well point of the Yin meridians; for example, Sp-1, Li-1, Ki-1. Then it goes up to Sp-6, it then follows the principal channel of the Liver and penetrates into the Liver; and there it stays during the night; during the day the cycle recommences. So you see that the circulation of Wei energy is a circulation according to night and day--different from the cycle of Ying energy, which is a circadian cycle of 24 hours. That's roughly what you need to know in regards to Wei Qi. I would like to draw your attention to this: up 'til now, when we talk about Wei energy, they often say that you have to treat the Lower Jiao, and they give you points to use, e.g.: CV-5, to treat the lower Jiao in order to augment the energetic potential of the Wei energy. But now that you know the different stages of the formation of the Wei energy, and if you want to have broader action than this, why wouldn't you stimulate at each stage of the formation of Wei Qi--that is to say, stimulate at the level of the Small Intestine, Large Intestine, Kidney, Liver, Bladder.
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I've spoken about Ying Qi, Jing, Wei; We spoke about the Middle Jiao, we talked about the Lower Jiao, and you will tell me of course that I haven't yet spoken of the Upper Jiao: we're going to talk about it now. The upper Jiao is where the Dong Qi exists; if you translate, 'Qi' is 'energy', 'Dong' could be translated as 'innate' or 'hereditary', or 'ancestral'. The chinese colleagues in Shanghai translate this term 'Dong Qi' as 'the energy of the thorax', 'thoracic Qi'. This is accurate, but not completely accurate, it is only part; I will explain to you in a minute why. Doctor Van Nghi preferes to translate this term by 'creative energy', and we will understand that in a moment, why he uses that term. The Dong Qi is found at this level, at the cardia. In order to understand Dong Qi we have to understand energetic embryology. We're going to digress for just a moment to discuss energetic embryology now: when there is copulation between male and female, Yang and Yin join, combine; and from here immediately you have a movement. There is a type of center, a core, here, which is constantly moving; because there is yin and yang there is constant movement. Are there any gynecologists or obstetricians here? Is there anyone here who has done lots of births? Is there anyone here who has done a lot of deliberate abortions? Has anyone done curettage here? But: if you do a curettage--in other words, if you cause an abortion on a woman who is pregnant approximately 28 to 21 days (now they use aspiration, so they don't examine the product which is taken from the uterus); in the earlier times, such as the time of Doctor Van Nghi, they always used to examine what was removed, so they were told always to look for this small core, which had to be moving, and if there was no movement that meant that the abortion was incomplete and there was still a pregnancy. This center, or this concentration, is at the level of the cardia. Since there is movement, there is yin and yang, so there is procreation and transformation, mutation or change. Coming from this movement there are lateral movements: try to imagine this small concentration which is still beating, still moving, at the level of the cardia. From this movement you try to imagine the phenomenon of creation, of transformation of the movement. First there is the formation of two lateral masses, which form a type of umbrella, which is none other, in fact, than the diaphragm. And the lateral mass which is formed from the concentration of energy, from this area, which is moving, moves up and down. Therefore the movement of the diaphragm is an innate or hereditary movement. That's why this morning when we talked about Bl-17 we told you it was the shu point of the diaphragm and we said it was a reunion point for blood; why? It is as the result of the up-and-down movement of the diaphragm that the energy of Yang Ming can descend and the Tai Yin can ascend, and it results from this descending of Yang Ming and ascending of Tai Yin that there is the formation of blood. This is why the point Bl-17, which commands the movement of the diaphragm, is also a meeting point of the blood. So the diaphragm: the first point is that the formation is very important. So first we have the lateral movements from the concentration of the Dong Qi; now there is a movement going 31
downwards, which forms the center of the Middle Jiao. That means that everything I told you earlier about the formation of the Ying Qi, etc., cannot exist without this point of concentration. Then there is movement towards the Lower Jiao; this means that from this point of Dong Qi there is movement which forms another point of concentration in the lower Jiao, and thanks to that there is the formation of Wei Qi, which we just discussed. There is also a movement downwards to form the Kidneys; and once the Kidneys have been formed, there is the formation of the osteomedullary system. There is also a movement downwards to form the Liver; once the Liver has been formed, the neuromuscular system is formed. So, to recap: first there is lateral movement; secondly, movement downward; and, thirdly, there is movement upward; why? To form the Lungs and their respiratory movement. There is a movement ascending to the Heart, forming the Heart and its cardiac movement. So, therefore, you can see how, starting with Dong Qi, you have the formation of all the elements which I've just described. Coming back to this term, 'thoracic energy', which was translated by our Chinese colleagues in Shanghai, I told you it was correct but it wasn't enough; because 'thoracic' really only applies to this part, but it doesn't include all this other part; and the term 'creative energy', which Dr. Van Nghi prefers, simply refers to the fact that from Dong Qi, all the rest is created. And this is the Dong Qi, the ancestral or hereditary energy. So now I've talked to you about the different types of energy; now we're going to talk about treatment. When you talk about treatment, and you talk about the San Jiao, they all talk about three points: the three mu points of the San Jiao; they say that the mu point of the upper Jiao is CV-17; of the middle Jiao is CV-12; and of the lower Jiao is CV-5. I would also like to point out that the upper Jiao, as you know, governs the Lungs and the Heart; the middle Jiao governs the Spleen and Stomach; and the lower Jiao governs the Liver and the Kidneys. Normally to treat the upper Jiao--you should only treat the upper Jiao when both of the two organs are being attacked, because if only the Lungs are being attacked then you only use Lung points, and again, if it's only the Heart you use Heart points--but when you have, for example, a cardiopulmonary condition, where both organs are involved, then you would use the point of the upper Jiao; and it's the same for the middle Jiao and, again, for the lower Jiao; only when both organs are attacked [do you use the mu point for that Jiao]. So let's go back to this: you know that all the organs and bowels have only one mu point but you see that the San Jiao has three mu points; this is already very important. But in 1982, when Dr. Van Nghi put out the book, The Art and Practice of Acupuncture, which is a translation of commentary on the Da Cheng, we noticed that there were not, in fact, three mu points of the San Jiao, ther are seven mu points for the San Jiao. We're going to try now to understand why. We noticed that when we translated
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and did the commentary on this book, the Da Cheng, we learned about the famous doctor of ancient times in China, his name was Pienn Tsio; he lived 200 years before Christ, and he said the following: "I agree with this point [CV-17]; and also this point [CV-12]; but I don't agree about that point [CV-5]." Why not? The reasons that the doctor gave were: he said that the mu point of the lower Jiao was not CV-5 but CV-7. Why? To understand that, we first have to know the name of the point, and we have to understand the idea that we talked about this morning, of the Dantien. At this level you have CV-2; between CV-2 and CV-8 you can divide [this area] into three parts; between CV-2 and CV-4 you have CV-3. We'll consider that all in a moment. We're now going to talk about CV-7: it's called Yinchiao: 'yin' means 'liquid', 'chiao' means 'reunion' or 'meeting', which means 'the reunion, or meeting, of liquids'. When I talked about Wei Qi a moment ago, I talked about the lower Jiao; you saw that from the pylorus right up until the final phase of the formation of Wei Qi you only see water; therefore the lower Jiao really is the metabolism of Water. And the point CV-7, Yinchiao, 'meeting point of liquids, for this doctor was a Water point which governed the lower Jiao. Now at the level of CV-3, we know that it's the front mu point of the Bladder; CV-4 is the front mu point of the Small Intestine; and the Small Intestine and Bladder together constitute the Tai Yang: Tai Yang equals Water. At this level it's considered to be the Dantien, we talked about this morning, the rice field; when you travel in asian countries you see that there are many rice fields, and you see them always full of water; this corresponds to this part. And you will see, of course, for the rice to grow there has to be sun; and here there is CV-6, which is 'Qihai', 'Sea of Energy'. Energy is Yang; Yang is heat, sunshine; so this point represents the sun. To help the water at those points, to help with the creation. This is why the Dantien region is extremely important in women, to the point where, when you go to asian countries you frequently see statues of the Buddha, and you see the Buddha putting his hand in this position; this is because he is hiding this region, because it is a sacred region, and it is an area of procreation for the reasons which I described. And the point Yinchiao, which is , is a point which helps procreation, because it leads water to the uterus. Because the uterus, in order to be fertile, has to be moistened or humidified. This is why, for Pienn Tsio, CV-7 is a point which commands or rules the lower Jiao; and it's a wonderful point to treat for sterility. But for the modern [choice], the point CV-5, they're also correct about it. Why? Because it's called 'Shihmen'; 'Shih' means 'stone', and 'men' is 'gate': 'Gate of Stone'. And what is stone? It is bones. And bones are what? they are the Kidney; because the Kidney governs the bones. And you know that the lower Jiao is the Kidney. So therefore CV-5 can also be a mu point of the lower Jiao. So in the lower Jiao you have: CV-5 and CV-7. So we've already got four [mu] points [for the San Jiao].
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The following generations of doctors said that they agreed about CV-17, and CV-5 and CV-7, but not about CV-12; because, as far as they were concerned, the point for them which governed the middle Jiao was St-25; but similarly for the moderns as for the ancients, CV-12 could also be the front mu point of the middle Jiao. Why? Because CV-12 is also the front mu point of the Stomach; St-25 is the front mu point of the Large Intestine. And you see that Stomach and Large Intestine form the Yang Ming. So you could use both St-25 and CV-12 equally well. So now we've got five points. In the Stomach there are points which govern or command the centers: the center of the upper Jiao, of the middle Jiao, and of the lower Jiao. The point which commands the center of the upper Jiao is CV-13; it's the point which you use to treat hiatus hernia. And for the middle Jiao you have CV-12, to treat stomach ulcers. And the point of the lower Jiao is CV-10, which can be used to treat duodenal ulcers. So, finally, we have: CV-17, CV-12, CV-5, CV-7, CV-13, CV-10 and St-25. So: seven mu points of the San Jiao, and not three. And to respond to all of these seven points of the San Jiao, you have the back shu point of the San Jiao, which is Bl-22; so when you want to act on this point you need to use moxibustion. And that's what I wanted to say, pretty much, about the San Jiao. I haven't had a lot of time, and I've tried to do a synthesis; I hope that you've understood. Thank you. Question: Can you tell us something about the point Bl-39? Answer: It's a special Ho point of the San Jiao, which you use to treat certain pathologies but not specifically of the San Jiao. There are three points: ST-37 which corresponds to Large Intestine, St-39 which corresponds to the Small Intestine, and Bl-39 which corresponds to San Jiao. But that's another problem. Thank you.
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Dr. Nguyen Van Nghi--clinique demonstration When did you have the accident, to get that scar? 11 years ago. So we're talking about a chronic problem; and you can see that he has muscular atrophy. So we can tell that there are nerves which have been attacked. But what is remarkable is that he can still move his arm quite freely, which is already a considerable advantage; because in principle, once there's muscular atrophy, the atrophy can spread to other muscles and the patient cannot lift his arm. In other words, at the same time as having muscular atrophy, he has muscular laxity. So if the patient had not had an accident, and if he did not have pain like now; if a patient came presenting these signs of atrophy in these muscles, without having had an accident, this patient would be presenting with very serious signs and symptoms; we would say that the patient had multiple sclerosis. The pulses are normal--he's had acupuncture treatment--since we're here, we'll talk generally about the pulses: in women, the right pulses are stronger; in men, the lefthand pulses are stronger. Why? Because often at the beginning, the French say, the right hand belongs to women, that we put it there out of politeness. Now we know that in this part is the pulse of the Lung, in other words, energy. And that the energy of the Lungs is the master of all the energy. The woman has more energy than a man. Look: we are two human beings; but she loses blood every month, so the woman only has energy; whereas the man has his energy and blood; this is why they say women have more energy than men, and that the man has more blood than the woman. This is proved by the Ren Mai and the Chong Mai: these come from the lower abdomen, in other words the region back there we were talking about, which is the area where the blood and energy arrive. In the man, these meridians originating in the Dan Tien ascend to the face, and that's why he has a beard and moustache. Woman has no blood at the time of her menstrual period, and the Ren Mai and Chong Mai are at that time in a state of deficiency of blood and energy--which is why women do not have beards and moustaches. But to come back to our patient, our president has asked us to relieve his pain and help his headaches. This morning I told you that in order to treat pain you have to look for the A Shi points, and to tonify the points of the corresponding channel. We can apply this theory to this patient. So now I'm looking for the painful points. Here's one--the pain is deep, so we would put the needle in obliquely and deeply, always not intending to go through the Lung. I'm looking for the most significant point--which is GB-21. So we have to puncture this point. Remember I mentioned this morning that when puncturing this point you can easily cause lipothymia in the patient. So its a point reserved for boxers: You've often seen on the television, the Japanese people are very small and American people are very tall, and they box on TV; the Japanese aim for this point. It's a very important point, and it's painful, so we have to treat this point.
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Our patient has explained to us the path of the pain; he has told us it's on the posterolateral portion of his arm, and it goes down as far as LI-11; we can also find pain on the posteromedial part of the arm, and he's indicated a point which corresponds to the Small Intestine channel; on the shoulder he has also indicated a point corresponding to the Small Intestine; and here there is a very important point: SI-10--and it hurts. In my opinion, all the three Yang of the arm are under attack. Now, how shall I treat him?--this whole area, not [just] the occipital headaches. I will puncture the painful points; I have established that the points situated on the three Yang are painful, so I will disperse these points, and then tonify the corresponding principle meridians. For example: here is the Small Intestine channel, so I would puncture SI-3, which is the tonification point; but to puncture it, you have to puncture it properly: this point is deep, you have to push it in so that it touches He-8, because the Heart and the Small Intestine constitute a Yin-Yang energetic system. After the Tai Yang, the Shao Yang: the San Jiao has a tonification point at SJ-3; I also have to tonify it. And the last Yang is the Yang Ming: which also has a point of tonification, LI-11. What I am about to tell you is applicable in all cases of pain: lumbalgia, tennis elbow, all kinds of pain. Under normal circumstances, there is no perverse energy in the system, there have been no traumatic shocks, and as a result the blood and energy are circulating normally. But if there is infiltration of perverse energy, which localizes itself at , the perverse energy is still foreign in relation to our organism, therefore this foreign body causes pain. This is penetration of perverse energy. Now we're going to talk about the case of this patient. This is the case of a traumatic shock. There has been a rupture or break of the vessels at this level--there's been a break of the blood vessels, nerves and energetic vessels. This is why the blood can no longer circulate properly towards the end of the arm. The blood and energy can no longer nourish the muscles and tendons. This is why there is muscular hypotonia. And over the long term, this causes muscular atrophy. So there is a blockage of blood here. It can't go in these directions. So now we have to unblock this. In other words, in the case of this patient, you have to not only tonify the principle channel, as we said this morning, we have to disperse not only the pain, but we also have to unblock this stagnation. And this morning I told you we have to use the xi-cleft points. So therefore you have to learn and understand the classification and the use of these points. There are about ten of these points, which you have to learn by heart. And if you don't know these points, you've turned into an acupuncturist who needles and doesn't understand anything. And we know the name of the group of points and their function.
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Now I'm going to give you the classification:
First, Ah Shi points;
Second, the Luo;
Thirdly, the Wu Shu (the Five Su-Antique) points;
--this is a very important group. If you know about this group you can vary the energetic potential of the human being. For example: if I'm cold, I'm shivering, you can look for a point and manipulate it, and you will change my state, and bring me some heat, warm me up; and on the other hand, with these points I can manipulate so that my energy corresponds to the cosmic energy. For example: now we're in Summer, my pulse is tight, it's abnormal, because the wiry pulse is a pulse which corresponds to Springtime; so if we're in Summer, the wiry pulse is abnormal. So if I go to your office, you will puncture the point corresponding to Summer, and tonify it, and you will help Springtime become Summer--which means that the wiry pulse of Spring will change into a full pulse of Summer. This group of points is extremely important--it is the basis of all practice of Chinese Medicine. I'm the first person in the world to describe the action of these points. Now the Chinese are speaking about them, but they still haven't demonstrated the certain way of practicing. Fourth, we have a group of points called Hui points--the Reunion, or Meeting points. --For example: in the case of this patient you have to tonify not only the muscles and tendons, but also the marrow; so we have a point for marrow--on the arm this is SI16; on the lower part of the body the marrow point is GB-39. You have to know these points in order to treat the afflictions of the marrow and brain. And now I'll give you another example: Bl-11, which is located here; I touched it a moment ago and it was painful. Bl-11 governs the whole skeletal system of Man; he's already told us that this point is painful, which means that his skeletal or articulatory system at this level is disturbed. Fifth, the opening point of the Curious Vessels; --you should know these, because a good acupuncturist, after having punctured the point of the principle meridians, always opens the corresponding Curious Vessel, in order to reinforce or activate further the points of the principle meridians. Sixth, the Mu points and the Shu points (Front-Mu and Back-Shu); --both of these types of points are extremely important; if you've seen on American television, certain acupuncturists have said acupuncture treats pain; but if you don't know about this technique, you're not going to succeed, because you are cheating--because at the same time you are prescribing medicine. So the Shu and the Mu points treat the
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organs and bowels. And this is very important. This means that Chinese Medicine, like Western Medicine, can treat any affliction. The results depend on the knowledge of the doctor--exactly the same as in Western Medicine. It's not because everybody's an M.D. that they can cure disease. There are M.D.'s and there are M.D.'s. There are acupuncturists and there are acupuncturists. Since this is the first time we've met, I'm going to give you an idea, to show you how important acupuncture is. The Mu point and the Shu point are the points with which we treat diseases of the organs and bowels. When there is deficiency in an organ, without a penetration of perv erse energy--for example, if we have cardiac insufficiency, or hepatic deficiency, or renal insufficiency-these are terms which are often used in Western Medicine; but they don't know how to treat them. We acupuncturists have a very precise technique for dealing with these problems.
know that in this area there are only Yin meridians that ascend, and you know that the Yin meridians travel in the Yin areas of the body. If we call a channel Yin, it means that it travels in the Yin part of the body; but in reality, it brings Yang into the Yin. And here, and the Bladder channel, for example, it is a Yang channel, because it travels in the Yang part of the body; but, in reality, it brings Water--if you don't understand the idea of Yin and Yang, when you're talking about points and meridians, how do you dare to do scientific experiments? That's why I've already said that all the scientific experiments of our time could be destroyed by me or you. What I mean is they don't understand WaterFire, Yin-Yang, and they're just experimenting. So the front is the part where the Yin meridians bring Fire.
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I will use the same technique: I will disperse the painful points. Here we're not talking exactly about the hemicrania, because hemicrania often begins in anterior and goes posterior. But this pain is caused by trauma; and we can relieve the pain, but we can't talk about hemicrania or cephalgia. To treat this patient I have to have him lie down. Now because of the AIDS problem needles have to be sterilized, and these needles are presterilized. But now we're going to question, 'are these needles which claim to be sterilized--are they really sterilized?'--I doubt it, because I've done a lot of sterilization of needles at the time of surgical operation; you need at least 180 degrees, exactly the same as the surgical instruments; and these Japanese needles are mixed with silver, and if you put real silver in a sterilizer it will melt. So the fact that they say they are sterilized is just to calm the patient down. Normally, with this type of problem, you would disperse with electrical apparatus, because you have to have a continuous dispersion. Our colleague, Dr. Youcha, has already done dispersion; [however] it wasn't in a continuous fashion, it was broken up into different treatments, that's why the results were not completely satisfactory. Notice my technique of dispersion; I turn the needle very quickly. If I want to tonify, I turn very slowly. I'm touching GV-14. No, it's not painful. I'm touching Bl-10 now, and he says its painful. So I'm going to disperse Bl-10. Now I'm touching GV-16; it's not painful. I'm touching GB-20, and he says its painful, so I'm sedating it--dispersing it. As he said, the pain ascends up the lateral part of the head. I'm looking for the painful points. Here there is a very important point, which is GB-8. It's not painful, so we won't puncture it. This is SI-10; look. I'm just touching the skin; now I'm going through the skin; and only now do I begin to turn the needle. If you just begin to break the skin with the needle and you begin to turn it, it causes a lot of pain. Watch how I puncture SI-3; you will notice the skin changes color just here; you see the 'head' line of the hand, you see the change of color at this point; this point is found at the distal extremity, it's situated below the metacarpophalangeal joint. I've just gone through the skin; I'm going to push it through right up to He-8. I'm tonifying, because I turn it slowly. But it's very deep. Small Intestine, San Jiao; and here I'm going to tonify the San Jiao. It's at the angle formed by the fifth and the fourth metacarpal bones. Now, there is a theory; everytime there is a disease in the upper part of the body, in other words in the skull or the neck, you have to tonify LI-4. I'll tell you why in just a moment. Here is LI-4; this is about right, I'm tonifying the three Yin. Now the disease is external, because if it had really affected the marrow, especially in that part, all of the area from here down to his feet would have been paralyzed, so we know that the problem is external, as the marrow has not been affected. This is why I have to puncture a point to provide this induction, to reestablish the connection between the external areas.
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Wai guan means 'external barrier'. It is located between the two bones, and I'm pumcturing it very deeply. And I am using the associated technique, which means that sometimes I tonify ,and then I sedate. I'm needling in the direction of GV-6. Now I want to reinforce the action of these points. I have to use the Curious Vessels. Now I have to look: have I used any points of the Curious Vessels? Notice that SI-3 is the tonification point of the Small Intestine, but actually it is also the opening point of the Governing Vessel. But the Governing Vessel is also associated with the Yang Qiao. Which means that I have to puncture Bl-62, in the foot. Here I punctured SJ-5, which is the opening point of the Yang Wei. The Yang Wei is associated with the Dai Mai, which means that I also have to puncture GB-41. Here I punctured LI-4, so automatically I have to puncture St-36, because LI-4 and St-36 are important points of the Yang Ming; this would mean that the points are correct. Why have I said now that this acupuncture treatment is correct? You know that the hands belong to the sky, and the legs, the feet correspond to the earth, belong to the earth. And Man has to respond to both heaven and earth. Man breathes in order to live; and eats the products of the earth in order to live. Now, man's body is ill--I've punctured all the effective points; and I've regulated his body with energy of the sky and earth. It's a very important theory in Chinese Medicine. We Americans, of course, are going to simplify everything: what does that mean--sky, earth? It shocks us a little bit. So we say, in order to treat an illness, first of all you treat the local points, the points corresponding to the illness, and regulate these points with distal points. What are distal points? They are the Su-Antique points. If you look at these points, they are all Su-Antique points. SI-3 is the Yu point; this is the Yu point; this is the Yuan point; that's the Luo point. So all the points from the fingers to the elbows, and from the knees to the feet, are Su-Antique points. This is the Ho point of the Large Intestine. Now I'm going to propose to our president: this is a demonstration. In order to really cure this patient, one would have to manipulate the needle in a continuous manner. In other words, you would have to stay with the patient and continue to turn the needles- which is not possible, because we have other patients to see as well. And, in America, time equals money. So we have a piece of electrical equiptment. You have to have at least two painful points, because the electrical apparatus has two leads, or it has one circuit with two clips. So here you have six points, so I would use three circuits. Following the technique of dispersion, you look at each unit and it has a light, the light blinks on and off like that. When you see that it's going very quickly, it means that it's dispersion; if it goes very slowly, it's tonification. And with this patient you would have to use a dispersion technique, and it would have to remain in place for fifteen to twenty minutes. Then you would take the needles out, and then the patient will feel a lot better than if you had done this by hand; no--because we can't stay there and do this by hand, it takes too long. But, anyway, in a while he will definitely feel a bit better. In other words, he would be having about the same reaction as he did in the treatment by hand. But if we're using the electical 41
equiptment, he would be radiant at the end of the treatment, he would feel very much better. Question: What areas would you treat with electrical equipment--that is, where would you put the positive and the negative leads? Answer: In all electrical stimulators they show it scientifically, they always use different colors to show positive and negative; but this electricity is separated into different wires. In other words they only act on movement. It makes no difference where you put positive or negative. The electric stimiulators were invented by the Chinese to replace the human hand, that's all. Question: Does it make any difference if you use copper, or gold, or silver wires? Answer: Makes no difference. It's the same question as: is there a difference if you use gold or silver needles--because in France, a long time ago, they used to use a lot of gold or silver needles. I have always fought against this. You simply need something that's hard, with which to puncture: for example, a toothpick--you would get the same reaction. In ancient times, they used to use fishbones; and even further back in time, they used to use jade needles--but these hurt, because they couldn't get them very pointed. Question: Is there a preferred direction, or plane, for the insertion ? Answer: In principle, you follow the direction of the pain. You pursue the direction the pain is traveling in. I feel that the pain will reach the lumbar region, and this is why I stop it at this point. Then I continue to disperse at this level. Any more questions? Question: What about the use of acupuncture staples? Answer: That's the same as needles that stay in for a long time, intradermal needles. Because we're in America,.... I'm against that method. Because if they stay a long time in the tissue, for example in the case of auriculotherapy, when they leave a needle in the ear, it's very serious because it actually causes a necrosis of the cartilage. And we're in the States. In China it doesn't matter, but in the United States this is important. We mustn't do that. As a result, in the case of chronic pain we have methods; why don't you use them? In all cases of chronic pain you have to use a technique known as 'heated needle': insert it deeply, and disperse it with your hand, and then you put moxa here and burn it. This is what we call the technique of the heated needle. The heat of the moxa follows the needle and reaches the deep and chronic painful area. Whatever is chronic there is always the phenomenon of what we call the transformation into phlegm. Here there is chronic phlegm, so you put heat on it and it disappears. And that cures the pain in coxatrosis--arthrosis of the coccyx. You have to use
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the heated needle technique. because in the case of pain in this area there is always a pinching between the cartilage. So you have to use this technique. But the Chinese are very Chinese: the ancient Chinese said: if you want to have a good result, when you use the heated needle technique you have to use it according to the lunar cycle. For example: the Chinese month has thirty days; on the fifteenth day of the month the moon is always full; and then the moon wanes; if your patient arrives on the fifteenth day of the month you have to do it fifteen times the same day, and if he came on the twenty-eighth day, you only do it twice. But all this is Chinese; I just do it once. Just to show you that Chinese Medicine is complicated. So tomorrow morning we'll be talking about the treatment of pain; and in the afternoon we'll be talking about craniopuncture; and then we'll either finish up with pain or do an examination of a patient. Pain is a very vague topic; I will be more precise. We're going to give as examples facial neuralgia, lumbalgia, sciatica, heaadache, rheumatic pain; all types of pain. And our colleague will also discuss neurological problems and how to treat them; for example: paraesthesia, multiple sclerosis, etc. To show you that acupuncture can treat all illnesses. You just have to know what they are.
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Day Two: Sunday, 18 September 1988 morning session Dr. Nguyen Van Nghi: I know that in the United States, as in Europe, there are problems in acupuncture which have to be resolved. Soon Europe will be unified: countries like Germany, Italy and the United Kingdom, etc, will have acupuncture studies which are very different from those now; for example: in Italy it takes two years, three years in France, three years in Germany, five months in Spain. It's impossible to make a united Europe with regards to practicing acupuncture this way. I am president of the European Commission, which is in the process of organizing a common program; in other words, three years of study in acupuncture for doctors; and these studies will either be at a private school or at the University. But for people who are not doctors, they will be obliged to do two years of western medical sciences, anatomy and physiology, either at a private university or at the university of their choice, before learning acupuncture. In other words, we are trying to resolve this problem. In the United States, as in Europe, acupuncture remains something of a vague subject; whereas in France, the government is beginning to deal with the situation. At the present time there are twelve universities officially teaching acupuncture, not including the considerable number of private institutions; whereas in Germany, for example, there are acupuncture services, which have faculty professors who are in charge of them; and in Italy there are official acupuncture services recognized by the Council of Europe--Italy is rather special, because in that country there is a lot of drug abuse, there are lots of handicapped people, there are lots of mental problems, psychological problems, and that's why they are the only country at the moment to have acupuncture treatment paid for by the state. I've roughly described the situation with acupuncture; and the Council of Europe is going to meet at least five times to resolve this problem. The first meeting was in June; the second is going to be in December of this year. This is why I'm in the process of inviting certain american doctors to come to the Council of Europe in the faculty as observers, with the idea of eventually establishing a program in the whole of the West. Because acupuncture as practiced in China cannot really be applied in the West; the way of practicing; because in the West there are lots of problems: for example, the problem of hygiene, scientific problems, and especially anatomical problems. It's completely impossible that an acupuncturist goes into the body of a patient. I'm confident that eventually the United States will adapt a similar program to that which is being recommended by the Council of Europe. Now we're going to talk about pain. You know that pain is a very current problem, not only for we acupuncturists, but also for the M.D.'s; also for the scientists at the universities. The problem of pain, at this time, has not really been resolved. As far as
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Chinese Medicine is concerned, we distinguish several different types of pain: emotional pain (eg: if you lose your mother), physical pain, and traumatic pain. Now we're going to talk about pain of external origin, due to perverse energy. Yesterday I told you that when there is a penetration of your body by a foreign object it causes pain. But when there's a deficiency of blood and energy in one part of our body, it can also cause pain. But if there is pain there has to be an obstruction of some type in the Luo vessels. In Chinese Medicine we first distinguish the Jing, or channel; the word 'channel' has been very translated: 'Jing' really means 'way' or 'path', 'pathway'--a pathway we can walk along, a route we can take. Whereas the word channel is more abstract, as the meridians of the sky--abstract. The first Jesuits who went into China translated it as meridian, and we've been folowing them ever since. So if we're using the term meridian, but we really mean channels which are material, concrete--not abstract. It's because of this term, 'meridian', that the professors at the universities are refusing to accept acupuncture: and now they're beginning to understand, however, that the word 'meridian' is a poor translation, and that we're really talking about an energetic pathway, which they have to find. So we're going to translate it as principle 'pathway'. And after the 'freeway', there are secondary 'roads', which we call Luo; 'Luo' means 'secondary way'; in fact, there are freeways, and national roads, and county roads. The Chinese call it Sun Luo, or county roads. We, because we are acupuncturists because we are doctors, we translate it as 'capillaries'; it's exactly like an artery < here's an artery>; there are, first of all, branches of the artery, and then there are small vessels [arterioles], and then there are capillaries. So the Jing and the Luo and the Sun Luo are exactly like a major thoroughfare, major freeway, which has branches and then smaller branches. So energetic physiology is esactly like anatomic physiology of Western Medicine. The capillaries, for example, may be attacked by Cold Wind; this causes stagnation, which causes pain. This is the first cause of pain. But perverse energy can also cause pain --and this part is normally irrigated by blood and energy, by Ying energy and Wei energy. And then it is protected by the energy of the Lungs, because the Lung rules the skin and the body hair. If there is a deficiency of blood and energy it causes a type of algoparaesthesia: 'algo-' means 'pain'; it causes a type of paraesthesis, a numbness; this is very important. When there is algoparaestheia, that is to say, pain with numbness, which means that you can't feel anything anymore, it's always because of the blood and energy. This pain is depressive in nature; whereas this pain, where there is perverse energy, or caused by stagnation of blood and energy, is a burning type of a pain. And this pain can also present in another form, which is the type of pain like a fist hitting you, or a prickling type of a pain, a stabbing or a pricking pain, or a cutting pain, as if you're being cut.
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So I've talked to you about two types of pain: a pain like a burning feeling, which is the excess type of pain, and the deficiency type of pain. Apart from these two types of pain we also have a traumatic type pain; in this case there is obstruction, if there is a blow or a shock to the skin there. Blood and energy can no longer circulate, and this causes pain. But certain types of traumatic pain are of purely material origin. For example: the ligaments, which join the joints together, when the joint is separated for some reason, also cause pain, that is when there is tearing of the ligament. This type of pain is included in the traumatic pain. The last type of pain is the emotional pain, which we also call psychological pain. If we lose a close friend, it causes a pain which is more a psychological pain. This type of pain is just as difficult to treat as physical pain. You know that Man has many different feelings: I'm now talking about mental pain. You've just learned about traumatic pain. The word 'emotional', or 'psychoaffective' has not been very well defined in the West. Roughly speaking, I am in harmony, in balance: you don't see my psychological faults; but when I'm sick, you can see that I may be an angry type of person, a sad type of person, etc. I am now going to define for you the feelings of a healthy normal person. In Man, there are seven emotions or feelings. I'm going to show you this according to the Law of Five Phases. The Law of Five Phases concerns the five organs: the Liver, the Heart, the Spleen, the Lungs, and the Kidneys. Under normal conditions the Liver has an emotion, a feeling. Yesterday Dr. Tran explained to us that the Liver absorbs Ying energy and gives off its Jing, transforms it into Jing. He talked about mental Jing, and Jing which governs different parts of the body, to be specific, different layers, such as the flesh (dermis), the muscle, etc. And then there is a Jing which rules the seven orifices, in other words: eye, ear, nose and throat, etc. Now I'm going to talk about mental Jing, psychological Jing, which is very important. The Liver has its normal Jing, which is given the name Hun. 'Hun', as we said yesterday, means 'vegetative', or 'material' soul. This means that all of us, in normal times, is capable of the feeling of creativity, of creating something. Fortunately, however, there are people who create very well and others who create very badly; for example, Picasso had the feeling or emotion or creativity to produce beautiful pictures. We wøuld say that his Hun was extremely powerful. Whereas I am completely incapable of drawing the body of a woman, for example; in which case I would of course say that my Hun is deficient. And I'm often angry, because I am not able to do what I would like to do, and when I'm incapable of doing what I want to, this vegetative or material soul turns into anger. So the Hun is the normal state; it's the mental physiology of the human being. Anger is pathology, from the point of view of emotional feeling. On the opposite end of anger we also have a normal emotion connected with the Lung, which is called Po, could be translated by 'sensitive soul', which means that every one of us has feelings of sensitivity. For example, Mrs. Reagan has a very sensitive soul;
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every Sunday she goes to poor peoples' houses and helps them. During the day she can't go there, she writes a little letter: "I'm very sad that I can't go." So in abnormal states, the sensitivity transforms into sadness. The Heart: the normal feeling or emotion is Shen; Shen means the 'mental', but the French translate it by 'mind' or 'spirit', and I am against this term. A person who has a mind, for example --'sense of humor' is another way to translate it. For example: a person like myself, I give little examples from time to time to make people laugh; so it's said I have a sense of humor. Whereas 'mental' means something else. What they mean by mental is a noble feeling, which dominates the other feelings or emotions. When the 'mental' cannot act appropriately, it causes emotion, either an excess of joy...; so emotion and excess of joy are pathological signs of the Shen. Opposite the Shen we have the Zhi; this means Will, Will Power. This means that the Will is an extremely important emotion or feeling, which has its home in the Kidneys. In practice, a man without any Will is a lost man. The Chinese don't say it that way; they say that when the Shao Yin axis is broken, man finds himself in a depressive situation. In other words, it causes madness. And what is remarkable is that Western psychiatrists, when they're describing a patient with mental disturbances, they say there is a separation of the Will and the mental aspect. This is why modern psychiatry, I think, is the same as Oriental psychiatry. Now, how should we treat this? This is what we should be interested in, because we are practitioners. If I am angry, I go to see you, you have to treat according to the cycle of inhibition (Ko cycle); in other words, with a person who is angry, you would increase sadness: for example, if I'm exhibiting a lot of anger among my friends and so on, you would come to see me and you would say, "Dr. Van Nghi, your son has just broken his leg". Now I'm talking about psychology, because psychology is very important in psychiatric treatment. We're acupuncturists, however, not psychologists, so we have to find a point on the patient's body with which to treat his anger. So our patient arrives angry; you know that anger corresponds to the Liver. You consider the Liver channel. You look for, among the Antique points, the point corresponding to the Lungs; you have to puncture this point: Jing-well, Yung, Yu/Yuan, Jing-river, Ho...The Jing-well point corresponds to Wood; the Yung point corresponds to Summertime; the Yu point corresponds to the Late Summer, end of Summer--Summer means the Heart, Late Summer means the Spleen; after the Spleen, are the Lungs for the Autumn: you have to open your book, you look for the point on the Liver channel corresponding to the Lungs- which is Li-4. so you puncture Li-4 to treat anger. So now I've talked to you about how to treat psychological pain. So now, imagine a lady patient arrives who has no Will; how would we treat her? Same principle. You have to know the Law of Five Phases. You know that the Spleen controls the Kidneys; the
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Kidney channel corresponds to the Will; I would have to puncture the point corresponding to the Spleen on the Kidney channel: the Spleen corresponds to Late Summer, so it's Ki-3. So you open your book, and you notice that the Yu point for the Kidney is Ki-3. This is why I told you yesterday that you have to know the Antique points by heart. Because if you know them you can treat all illnesses. If a young girl comes to you in a very emotional state, you'd say: 'what emotion is it, what organ does it correspond to?' Supposing it was the Heart; it goes from up to down. You have to use the cycle of inhibition, so you have to use the Kidney point of the Heart [channel]; so again you use the technique of the Antique points. Jing-well points, Yung, Yu, Jing-river, Ho: Kidney corresponds to Winter, so you need to puncture the Ho point of the Heart; you open your book and you find that it's He-3. So, He-3 treats an excessively emotional state--because there are people who are much too emotional; they can't be in front of the director of a company, or someone important, or even in front of their friends--they're always withdrawn, they've lost their joie de vivre, joy of life. You have to puncture He-3, tonify it. So again I've talked to you about how to treat psychological pain. Let's take the case of nervous breakdown, nervous depression. In this case the patient is often extremely anxious, and he presents other signs, for example: insomnia, bulemia or maybe anorexia; you have to add additional points in your treatment. But Chinese Medicine does not talk about five emotions but rather seven: sadness--if the Pro, that is the Lungs, is under attack, this sadness is always followed by lamenting or complaining; when the emotional aspect of the Kidneys is attacked, there is always fear, and this fear is always followed by tears, weeping; So we can count seven emotions altogether. I forgot to talk about the Spleen: the emotional aspect of the Spleen is the Y: the thought process, thinking, or reflection. When there is no reflection or thought, the patient is always preoccupied, worried, we talk about worry. So there are seven altogether. So I've talked to you about the seven psychological entities of Chinese Medicine and how to treat them. Now we're going to talk about how, in general terms, we will treat physical pain. Imagine you have a sprain, in other words a tear of the ligament. Let's talk about something very common, which is the sprain of the ankle:
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do this?
stimulator. Because I can't stay there and manipulate by hand. Since we're coming into the twenty-first century, we have all kinds of technology that we can take advantage of. And you will have 100% recovery with this technique. We're going g oing to leave tomorrow; but I'm sure some of you will begin practicing this technique, and you will be extremely happy; you will even be delighted and amazed. I also talked a moment ago about pain caused by a deficiency of Blood and energy. For example: in the case of facial neuralgia, in Western Medicine they always talk about neuralgia of the Trigeminal Nerve--and they don't cure it, they never cure it. Whereas Chinese Medicine is very precise; when we talk about facial neuralgia, we have to look for the cause: is it the Cold, is it Blood stagnation, is it psychological, or is it because of a deficiency of Blood and energy? When it's a pain caused by a lack of Blood and energy, we first puncture the painful points. Then we tonify Blood and energy.
type of problem in the upper part of the body, the head, there is always a deficiency or disturbance of essential energy, vital energy, tthat is, the energy of the Spleen and Stomach. This is a theory that you're not going to see--I don't accept this, I just state the theory because, as I said, in Western Medicine theories only last six months and then they change. Now we say: I can't change it; I will have to explain it to you. , reaches this point and then it's the same thing, exactly like the other side. However, the Tendinomuscular channel, from LI-1, there are many little vessels which in a general sort of way ascend to the face, and arrive at St-8; and from St-8, there are, again, a whole lot of little vessels which go across the forehead and reach ; and from there, they go down on the opposite side and they spread into the cervical region of that side. And on this side, the same thing; it goes up, it turns around and it descends . And it terminates on the opposite side. This is why, when you have a problem at the level of the head or the face, you always have to puncture LI-4 in order to free up these small vessels.
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Nerve that is the cause of the problem; if it were the Trigeminal Nerve, then once you inject an analgesic product it would be immediately cured. But it isn't. Let's suppose that it is the Trigeminal Nerve, because science has told us this, and we have to listen: so we say that on the Trigeminal Nerve, especially the second branch, the point SI-18; And for we acupuncturists, SI-18 is located there, so we are very clever--to keep our colleagues the MDs happy, we say that it's accurate, and we say that we're treating according to the Western idea of physiology. So we would puncture SI-18; and the MD, looking at your treatment, would say, 'Of course--you've punctured the second branch of the Trigeminal Nerve.' So we all agree on that. But of course we are really only doing it because of SI-18. Because in every case of facial neuralgia, this point is always very painful. If there's pain, I would turn quickly. And this pain often radiates to , which is SI-19; and this pain also often goes to the eye. This is why, during an attack of the pain, there are tears; eyes closed like that, and the twisting of the face because of the pain--because the pain is also causing muscular spasms in the face. But we don't describe it that way; we say, when there is pain it injures the pathways of the meridians, and the meridians are often found in the muscles, and that's why there are muscular spasms. I'm showing you the existence of the channel because under normal circumstances, there are no meridians. As I sit here at this moment, I don't know if I have a Heart or Lungs; but if I have dyspnea, I would be very aware that I have a problem with my Lungs. Health, that is, the human being in good health like me, I'm whole--ask me about my eyes, as far as I'm concerned I don't have any; I don't feel my arms; but if I have a pain in my shoulder, I'm always thinking about my shoulder. So the Chinese say: when there is pathology, my shoulder, it's separated from the other parts of my body. This is why, to treat external diseases, I have to reestablish the connection between my shoulder and the other parts of my body, that is, the external parts. Now, if I had a stomach ache--because you don't even know that you have a stomach right now, right? You're listening, you're not being conscious of your stomach, because you're feeling OK; but if you had a stomach ache, the Chinese Medicine doctors say, you're stomach is separated from the other organs and bowels. A good acupuncturist, before treating you, would reestablish the connections between your Stomach and the other organs and bowels. But we have points, to treat all external afflictions, or to reestablish the connection between the sick part and the other parts; we have to use SJ-5, Waiguan. 'Wai' means 'external'; 'guan' means 'barrier'. So in all external problems, if you're really traditional, you would use SJ-5. For example, if this lady needled this gentleman, and I observed how she was doing it, if I were really traditional, I would have no reason to ask anything; I would know exactly what she was doing, because we have the
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same knowledge; for example, if you were puncturing SJ-5, I would know that it was because he had an external problem with his shoulder or his leg or whatever. Now if it's a question of an internal illness, Lungs, Heart, Spleen, etc., you have to use Pe-6, the point opposite from SJ-5 (which is Waiguan, Wai means external); Pe-6 is Neiguan: 'nei' meaning 'internal'; 'guan', means barrier. Remember that in cases of pain of facial neuralgia, it could be caused by an invasion of cold wind; it could be due to a compression of the nerve of the pathway of the channel; it could also be caused by Stomach heat, or it could be due to a deficiency at the level of the face; in other words a deficiency of yin, of Blood. When there is a deficiency of yin, Blood, there is always an excess of yang, energy. This morning I talked about a neuralgia which causes a pain that is like a burning sensation. The pain during an attack may last only one second, or for one to two minutes. During an attack there are always muscular spasms. This is why we must reach the painful points on the face. We've established that SI-18 is always painful; this also often involves LI-20 which is also painful. On the forehead, GB-14, may be painful; SI-19 may be painful; the pain may also radiate toward the region of the chin, by the lips; but the central area is always SI-18. So we have to puncture and disperse these points. To puncture SI-19, you have to ask your patient to open his or her mouth, because this point is situated between the ascending branches of the mandible; when you open the mouth: , you can put your finger , and this point is SI-19; below is GB-2; above it is SJ-22: therefore, in this hole, there are three points. So if you look in your book, you see "1-2-and-3". But this is only to show students; in practice, the middle point is slightly over to the side. When you ask your patient to open the mouth, you put the needle in, deeply--you put it in to two or three centimeters, about one cun--if you don't ask your patient to open the mouth, you hit the bony protuberance of the jaw, so you're blocked, you can't put the needle in. It is the only way to get good results. This is why the technique of manipulation and the technique of acupuncture is very important. Let's suppose we want to needle . I ask her to open her mouth. Before opening it, you can't get the needle in, it's blocked. Open--there's the hole. Q: After the needle is in, can you then close the mouth? A: Yes, you can relax the jaw. But don't bite down. If you don't reach the point, which is at a deeper level, you won't get results. Another example: when you treat tinnitus, you have to press on this point. If you are talking about the Kidney channel, you know that the Kidney rules the ears; when there's a deficiency of Kidney energy you press on this point and the condition will continue to manifest. If it's of external origin, especially if caused by wind, when you press
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on this point the ringing stops. This is very important, that's why I've noticed that many of my colleagues who treat this condition of ringing of the ears treat the name of the illness and not the form. If it's caused by the Gall Bladder, in other words, wind--because the Gall Bladder and the Liver constitute an inseparable system of energetics which corresponds to wind--you have to treat at the level of the Shao Yang. If it's caused by the Kidneys you have to treat at the level of the Bladder or the Kidneys. This is the secret of acupuncture. If you only treat the term tinnitus, ringing of the ears, you're only going to succeed one time out of a thousand. When you know the cause, you have all the techniques possible to treat the origin of the disease. And then when we cure our patient we are happy. Whereas if you don't know this technique and you don't cure your patient, you don't know why not. I just told you that the principle point to puncture in the case of a facial neuralgia is SI-18. The pain may radiate towards SI-19, or towards Bl-1, towards CV-24 ( in other words, towards the chin), or may radiate towards the labial region, in which case you would puncture GV-26. This is local treatment, to relieve pain. If you have pain and you don't treat the cause, it will come back, exactly the same way as if you made an injection of cortisone. You don't know the cause of the pain; three hours later it comes back. Here we're talking about wind cold, for example: the point to puncture would be the point of wind.
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Pole, there's only Cold up there, there isn't much Wind; I wouldn't catch cold, I would feel cold, but this Cold wouldn't penetrate into my body. This is why in Chinese Medicine you often come across the terms, for example, Wind-Cold, Wind-Heat, Wind-Humidity, etc. But there are illnesses which are caused only by Wind. So when you talk about Cold, what you really mean is Wind-Cold. You should understand this, otherwise you could come across these terms in American literature, and you're not going to understand them. Even in Chinese literature. These terms have to be understood well. In the case of facial neuralgia, it's very often Wind-Cold which penetrates. But, of course, the Wind itself can also cause it. And Wind-Heat may also cause facial neuralgia. So we need to treat Wind. What points shall we puncture? This is very important. I just explained the case of someone who comes with ringing of the ears, tinnitus. And I suggest puncturing SI-19. I manipulate the needle. During the manipulation of the needle she immediately feels better. But if I don't use SJ-17, when I stop the manipulation she's going to feel the pain more. To puncture this point in this case, ; I would orient the needle towards the upper part of the ear. You have to be very careful, it's an area where the jugular vein passes. Before puncturing, you should massage a little bit. So you massage , so you look for the jugular nerve, and you try very hard not to puncture it, you orient the needle towards the ear to treat the ear. Now, facial neuralgia: it's the opposite direction, you have to orient the needle towards the face, and you turn it, and in this case there will be a sensation of coolness in this area. This sensation of coolness immediatlely gives a sense of relief to the patient. So in the treatment of facial neuralgia, the principal point is SI-18, and then you look for the points, the so-called secondary pain points, in other words you look for where the pain is radiating, and as a result you puncture there. Supposing that this lady has a pain which is radiating up towards the forehead; there is GB-14, and here, SI-19; I would puncture point straight in, deeply, and obliquely, because if I puncture straight I will touch the skull. And since the central area of pain is in area, I would orient the needle towards that area. And then I would join the points with an electrical stimulator to disperse them. Supposing the pain of facial neuralgia was located in area, and radiated towards the upper lip: is the principal point, and I would have to puncture , St-4, and is GV-26. If the pain is I would puncture , but I would orient towards GV-26. If the pain is I would orient it in direction. This is very important. I have to use two needles in order to join up the electrical stimulator. Good acupuncturists have to know very well the pathways of the Channels, and not the drawings which you see in the books, which are not completely accurate. Frequently, according to the diagrams in the books, it looks like would be the channel [Foot] Yang Ming, the Stomach; but that's not exact: this is just for students; we need something better. is St-3; the mouth looks like this; there is the point , and here. The 55
energy of the Stomach, when it's reached first of all goes to GV-26, and then it goes to St-4, and then it goes to CV-24, and then it goes to St-5, and from St-5 directly to St-8. And so there is no joining, it doesn't join at all between points. This is why the pain radiates in directions. This is why we have to know, by heart and in depth, the pathways of the channels, which are our energetic physiology. Accor ding to where the pain radiates to, which is the case, you have to add GV-26, CV-24, or St-4. Conclusion: To treat neuralgia, SI-18 plus the Ah Shi points, all of those are Ah Shi points: SJ-17, LI-4, St-36, SJ-5. And the cure is almost instantaneous. But since it is a disease which is difficult to treat by an MD, even if the patient feels better, you have to do it 12 or 15 times, otherwise you don't earn any money. But don't cure them too quickly, because this is a question of ethics. For example, in the three months my colleague has been treating me I haven't felt better; so I go to this lady; I know that she knows a lot about acupuncture; she uses these points, and I feel better. She has to respect her colleague; you have to take advantage; so you do 10 or 12 treatments. So you should see your patients at least 10 or 12 times. If he or she gets better the third treatment, you absolutely have to tell them that "if you don't continue these treatments, the pain will come back". This is what medicine is all about--it's also commerce. Especially acupuncture! Never cure an illness in two or three treatments. Don't do it--because the MD's don't like it! And your colleagues, too. [Note: this was said tongue firmly in cheek.] I've just talked about facial neuralgia. Now I'm going to talk about headache, cephalgia. It's the same thing: you need to know the cause, you have to know the clinical signs, in order to be able to apply an appropriate therapy. In general, you need to know that all the Yang Channels ascend to the head. You know that the Yang Channels bring Water towards the head; because the brain is the place of mental activity, so the brain is always overheated, and our body has to constantly bring Water to it to cool it down; like the engine in your car, you always have to have water to keep it cool. And the meeting point of Water on the head is Bahui, GV-20. So when there is a disturbance of the three Yang of the hands, especially disturbances caused by a penetration of Perverse energy, it can cause cephalgia, heaadaches of so-called exogenous origin. But the head, the skull, is also the point where the Jing is concentrated. When there is a deficiency of Jing, it also causes pain; the Jing is located in the interior of the skull, it is the 'quintessence'. In the case of deficiency, it causes a cephalgia which is intracranial, which is called, in Western medicine, encephalalgia, in other words in the interior part of the skull. But there are also vessels carrying blood and energy to the head. In the case of deficiency of blood and energy, caused for example by a hemorrhage, or a post-partum metrorrhagia, or a serious illness of long duration, this can also cause cephalalgia, but in this case the headache is of internal origin.
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Now we're going to talk about headache of external origin. This is always caused by Wind-Cold. Wind-Cold attacks the Channels, causing headache, which we describe as headache of external origin. We know that we have three Channels: Tai Yang, Shao Yang and Yang Ming; are three Yang Channels, the Cold attacks the Tai Yang, ascends towards top of the head and causes a headache which we describe as an occipital headache. When Wind-Cold attacks the Shao Yang, which as you know travels in area [temple], we say when Wind-Cold attacks the Shao Yang there is a temporal headache, or hemicrania, lateral headache. When Perverse energy attacks the Yang Ming, and I said this morning that the Yang Ming covers the forehead, in this case we have frontal headache. But Western medicine also talks about headaches at the vertex, in other words at the top of the head. They've talked about headaches which are at the vertex, but they are not able to treat them successfully. But we can treat them for sure. I already said that GV-20 is where the three Yang join or meet, but the channel of the Liver, when it reaches Li-14, also ascends towards GV-20. I also mentioned that GV-20 is the Meeting Point of Water. Plants are the root, they look for a place where there is water; that is why when the Liver channel reaches Li-14 automatically there must be a vessel which ascends towards GV-20. This is very important. In the case of headaches of the vertex, you would ahve to disperse GV-20 and you have to puncture Li-2, otherwise you won't get any results. We have to be precise. Once you puncture Li-2, you do a strong stimulation. If this lady comes in with a headache of the vertex, you puncture this point, she is immediately better. Or you disperse point, and she is still much better immediately. Again, we're demonstrating the reality, the existence of the Channels. Another example: if this lady comes with hemorrhoids, she won't want to sit down, with a full atttack of hemorrhoid pain. She comes to see you, you simply puncture GV-20, you orient the needle towards the back, . And you turn the needle quickly. She immediately feels a freshness or coolness in the area of the anus, and she says, "I have no more problem with the hemorrhoids." Once again this demonstrates the existence of the Du Mai, the reality. So there isn't any point in doing scientific experiments on animals, which is what they do now to prove that acupuncture is a reality. Another example, when you have angina of the chest, in other words cardiac pain, you have a pain which radiates from the thorax to the little finger; in Western medicine they haven't been able to prove that the heart has a nerve which reaches the little finger, but Chinese Medicine has proved that there is an energetic pathway that goes from the heart to this point. This is very important. This is why at the moment in Europe the question of channels of energy is already proven. And in 1971 I showed the Americans in the important areas here in acupuncture. They did research, and it's since that visit to the United States acupuncture has begun to spread in the United States. Unfortunately, however, at that time I had a lot of things to do, because my duty was to convince the Europeans first, and then I had to convince the Americans. So now
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I've come to convince you, that acupuncture is a medicine--it's not a therapeutic technique, it is a medicine. It consists of studying anatomy, energetic physiology, diagnostics, different therapeutic methods, and pathology. In other words, it is a complete medicine. It is not adjunct to Western medicine. We have a duty to confront the two types of medicine: because Western medicine is based on the material, whereas we base it [i.e. Chinese medicine] on energy. Man is a mass; this mass has to contain energy. When the two types of medicine are considered together, we will have a medicine which we can call universal. I hope that we can reach our goal, and I think that's beginning now. I'm very proud that, at the moment Europe is becoming interested in traditional medicine, to develop opposite Western medicine, and not just for a little treatment as an adjunct to Western medicine. I've just talked about headaches of external origin. We are traditional. But we live in the United States. We have to obey the law of the Americans. We can't talk, for example about headaches; we have to talk like the MDs: there are occipital cephalgias, lateral headaches, those of the top of the head, and frontal headaches. But we're going to show the reasonings of Oriental medicine. I've already showed you the reasoning of Oriental medicine: for you, when it's a question of occipital headache, you have to treat the Tai Yang; when you have a temporal headache, you have to treat the Shao Yang; in the case of frontal headaches, you have to treat the Yang Ming; and a headache of the vertex, you treat the Liver. So it's easy. Occipital headache, you puncture Bl-10, GV-20, and the Ah Shi points. But since the Bladder goes from the head to the feet, and the Bladder has another branch called the Yangqiao, which goes from the lower part to the upper part, we have to open this point--Bl-62. This is the way we treat occipital cephalgia. But we always have to use the Curious Vessels. You see that this part [the forehead], especially the center, is traversed by the Dumai, the Governing Vessel. And on the foot, we have the Yangqiao, which ascends. So Yangqiao has to associate with Dumai, Governor. So you puncture SI-3 and Bl-62. Bl-62 you've already used, so you have to add SI-3 so the treatment will be complete. But it's still not finished, because the illness is of external origin. So which point do we use? SJ-5. Because you had a headache, and now you've rejoined your head with the rest of your body. So when you do this treatment, the first treatment you will have at least 70-75% satisfaction, and the patients, when they leave your office, they will be very happy. Now temporal headaches: you know that the Shao Yang travels on the lateral area of the head. When Perverse energy attacks this area it causes lateral headache. The treatment is easy: you puncture the painful (Ah Shi) points, and you look for the most important points in this area; and we've established that there is one very important point, which is GB-8. This area , above the ear, about two fingers' width, it depends on how heavy the person is, because you're traditional you say you have to look for a point where the three sutures meet: the frontal, temporal and parietal sutures. You 58
touch it , and the point is When I press on it, she feels the pain, which radiates towards the front or the back. In other words, this is the central point for treating hemicrania, or lateral headache. We also have to add a temporal point, the curious point of Taiyang, ; if you put your finger on this point, you feel a pulsation, an arterial pulsation; this point is located on the superficial part of the temporal artery. You know that among our clients we frequently come across a disease called arteritis. The artery here is swollen and hard; it's as hard as a tight string. The pain is atrocious, and the patient might even faint, in which case you must not puncture. You have to bleed Curious Extra point-9. Don't worry, you can cut the artery if you like. , not deliberately. Because they are unable to really show the existence of these vessels scientifically in treatment. This is the first time that I've met you; I'm going to give you the greatest number of ideas that I can. We know that Principal Channels have points. You know that, to treat an illness, you always have to puncture these points. It's too easy, we don't need to learn anything. You only need to take the page and look at the points, and then puncture the points. Now we have to define the points of the Principal Channels. It's the place of confrontation of Ying energy, and from these points there are many small irradiations which lead to the area which you're considering, which nourish, because we're talking about Ying energy, which is nutritive energy. When the Perverse energy is in the Lo vessels, point is obstructed because it is unable to circulate. To be able to circulate, the points have to be open. You know that acupuncture points--it's not because all the points are open, they're only open at certain times, but this is too advanced. This is very advanced; if I come back in a couple of years, then we'll really be able to talk about acupuncture, real acupuncture. Apart from these points, which are called channel points, we also have curious points--they're very curious, because they're not on a channel. They've always told us that the points are on Channels, and now we are learning there are points that aren't on the Channels. What are points that are apart from the Channels? It simply means that they
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are points which do not form part of a channel. Example of these points: Yintang; we have to know the meaning of the word, "Yintang"--it means "the sign of the forehead", that's the definition of "Yintang". The trace of the energetic line, the energetic pathway, so it's not a channel, it's just a trace of a pathway. What type of pathway? You know that the Curious Vessels have points which were discovered at the same time as the Principal Channels, always. Which means that the Curious points were discovered at the same time as the points of the Principal Channels. In classical literature, such as the Nei Ching, they talk a lot about Curious Channels. To be a good acupuncturist, you have to know the whole medical system, and not just one small part. Now I've given you a definition of these Curious Points: it's the place of reunion of Jing energy. Dr. Tran talked to you yesterday about Jing. For example, the Jing of the Spleen goes to the dermal area, but when it arrives there in plentiful supply, it accumulates. The energy circulates in . The energy circulates like . You might have seen it on the television, they've shown how energy circulates in the Cosmos. And it's exactly the same thing in Man. If the energy has made its circle in this area, it makes another circle and continues. But it makes circles that are so deep that it stays down below. Now I'm talking about the skin. We have the Jing of the skin, of the Lungs, and this Jing continues to circulate. But there are areas where it's much deeper; so the Jing energy stays there, then it continues to circulate. And they are the Curious Points. The Curious Points belong to the Jing. They've taught us, even in modern Chinese texts, the Yintang is the meeting point of the Jing of the Lungs. Zhongquan, this is the reunion point of the Jing of the Heart, etc. So the Curious points are equally as important as the points of the Principal Channels. I have described approximately 200 Curious points, and our contemporary colleagues of China have invented another group of Curious points called "new points"; in reality these are Ah Shi points. The new points are not quoted in the Classics, whereas the real Curious points are those points which are mentioned in the Classical literature. The points on the ear are part of these Curious points, because the Jing of the Kidney ascends to the ear and spreads out towards the outer ear. Yesterday Dr. Tran told you that the Kidneys contain the Jing of the other organs. As a result, at the level of the ear there are points of all the organs, which is where the technique of auriculopuncture arose. But, for example, in the United States they copied the French method; they don't know why there are points on the ear, and they say that they're talking about 'auriculomedicine'. And that's not true, not serious. They're just talking about technique, not a medicine. A therapeutic method is quite different from a medicine. For example: if my Liver is ill, if I have a problem with my Liver, I will tonify or disperse the middle point of the ear. I have a pain in the wrist; there is a point on the ear
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corresponding to the wrist, I will puncture that point. It's beautiful: the treatment's very easy. The treatment's not like that! That's the Franco-American way. The Chinese technique is different -- you have to define: perverse energy only penetrates the Channels, into the Ching (ie: the Principal Channels), and the Lo Mai and the secondary vessels, the different types of Channels, but it never penetrates into the Jing. Jing, as we saw, is created in the interior of the body. The Jing, if you want to use the term, could be regarded as 'hormonal'. That means that all problems are of 'hormonal' origin. But this is too western. All internal disturbances can be treated by the points on the ear. But this treatment has always got to be associated with somatic puncture. Which means that you have to puncture points on the Principal Channels, in addition. Whereas, at this present moment in the west, the subject will think that puncture of the ear is enough, that you're practicing Oriental medicine. It never gives satisfactory results. This is why our French and American colleagues have not yet managed to establish real statistics. For example: there are peasants with dysmenorrhea; they puncture the point corresponding to dysmenorrhea; it calms the dysmenorrhea. But in other cases it does not cure. They can't prove it. We immediately know, therefore, that the dysmenorrhea, therefore, is of psychological and internal origin. And since we're acupuncturists, if one of our colleagues were treating a patient by ear points who doesn't get better, when the patient comes to us we know we have to puncture points of the Principal Channels. I'm sorry I have to stop there. After lunch, if we still have time, we will continue talking about neuropsychiatry. Because in Western medicine, when we talk about pain, pain as a whole is regarded, is considered to be neuropsychiatry. Because, although we're traditional, we can still use Western medical terminology. Thank you.
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Sunday, 18 September afternoon session Dr. Tran Viet Dzung: I personally have practiced acupuncture since 1969, so as of yet it has been nearly twenty years that I have been practicing it. There are lots of things I am not sure about. There are three things that I am sure about that I would like to explain to you in a very simple way: First of all, the further I get into my studies of acupuncture the more I realize how little I know, that I know nothing; Two: among my patients there are lots of failures, I fail to cure a lot of people. But there is one thing I am sure about: that if I don't succeed in curing my patients, it is not the fault of acupuncture: I haven't reached the height of my prowess, I haven't reached the peak of my possibilities and achievements. There is acupuncture and there are acupuncturists. Thirdly, I notice that often when I fail to cure someone, it's because I haven't properly grasped the technique; that is, I use a technique, often, that I haven't really understood. That's why I believe, that when you puncture a point in acupuncture, you have to understand the meaning of that action, you have to understand the meaning of what we do. We have to understand the deeper meaning of acupuncture. Because if you puncture a point, and you don't understand why you're puncturing it, if you're just doing it because the Chinese say you that have to do it, or other people say you have to do it, if it's just a 'reflex' point, without any proper interpretation or real understanding, according to my experience, the results are not good. As I said, I've been practicing acupuncture for almost twenty years. During the first four years that I used this method, I didn't have a lot of results. I didn't have the results because I just used the zones that I'm going to talk about without really thinking about them; I didn't have a clear understanding of my actions. The day on which I really began to really understand it, I began to have better results. You have to understand two basic ideas: the first is the idea of the Kidneys; and the second is Jing. We're going to think about the idea of the Kidneys first. You know that the Kidneys in oriental medicine is something extremely complex; it's not like in western medicine, where they are only involved in the filtration mechanism, glomerular filtration and urine excretion. The Kidneys in oriental medicine have several functions: the first is what we'll call the function of hydrogenesis, which enables us to have what we call organic Cold. And this function of hydrogenesis happens as a result of what we call Kidney yin. The second function is that of thermogenesis; this function is to produce heat, organic heat, the heat of our bodies. And we attribute this function to the yang of the Kidneys. The third function of the Kidneys is that of sexuality and procreation. This includes the function of spermatogenesis, production of sperm, and we can treat problems such as spermatorrhea. It also includes the process of ovulation, and we can treat, for example, problems such as sterility. It's an organ of procreation, as a result of two channels: the Curious Vessels
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