"Regarding the rediscovery of Fu Xing Jue" - translated excerpt from Dun Huang Gu Yi Ji Kao Shi 敦煌古醫籍考釋 (Commentary and Research on Ancient Medical Texts Excavated in Dunhuang, Ma Jixing 馬繼興
It nice to see one's work critiqued by a sincere reader; even nicer when the review is positive!
Steve Clavey, editor of The Lantern, is clearly familiar with the original Chinese version of this book. His review of the recently published English version, the translation of which I contributed to, draws upon this familiarity to emphasize an important point:
"...anyone who is drawn to take a deeper look at Chinese medicine theory should own and read this book. But it should not be read as a bible, or to “find out what is true” or to memorize."
The author of this book, Liu Lihong, is a brilliant contemporary Chinese philosopher, writer, and commentator in the tradition of Lin Yutang and Chiang Yee (The Silent Traveller), to name two that might be familiar to an English-language audience.
Although this book ostensibly focuses on the relatively specialized field of Chinese medicine, his observations and inquiries are broadly relevant to the larger fields of Chinese philosophy, religion, language, and society.
"Opening Classical Chinese Medicine at random, I come across this phrase: 'Looking briefly at the simplified form of the character mai (脉), the original meaning of the character yong (永) was ‘long’. When this concept of ‘long’ is placed within the frame of reference of history, it might be taken to mean ‘eternal’. When placed in the context of the natural world, this idea naturally resonates with the image of a river, long and constantly flowing …' and so the passage continues, linking pulse to the flow of water and to the moon, and the link between the moon and water, with its tides and cycles, rise and fall. This is the type of thinking that can plumb deep and draw to the surface meaning unavailable to shallow dippers."
I'm pleased that Liu Lihong's distinctive approach to mulling over challenging questions has come across in this English translation. One of the joys of translating this text was in appreciating this approach -- taking apart the questions, tracing characters and phrases back to their sources in classical texts, and then bringing it all together to expose new meanings and interpretations.
I'll leave Steve with the last word:
"This is a book to weigh and consider, and rather than take it as dogma we should be considering and attempting to verify its conclusions in our lives and practices. Of course, that takes thought, and everything around us these days encourages us to leave the thinking to someone else."
Please read Steve Clavey's full review in The Lantern here:
The book can be purchased by the US distributers here:
I've been spending so much of my volunteer time on acupuncture-related legislation recently that when I was contacted about writing something for our local Crazy Wisdom journal this topic naturally sprung to mind . . .
Which state do you think was the first to legalize the practice of acupuncture? You are probably thinking California, right? Or maybe New York? Did any of you guess Nevada?
This is an unedited case study from my forthcoming book on chronic inflammation and Chinese herbal remedies. This case study is a translation from the Chinese, and it details the recent treatment of a patient with chronic canker sores by my teacher Dr. Peng Jian, of Changsha, China.
It is notable because of the successful use of warming herbs, in a condition where they are usually contradicted. This case study is posted as an example of the treatment of a chronic inflammatory condition with herbal medicine, and is not intended to provide diagnostic or treatment advice. Enjoy!
Liu X, male, 33 years old, resident of Changsha
First Visit: October 6, 2012
For more than ten years this patient had recurrent ulcers erupting unceasingly on his tongue and throughout his mouth, which only healed up for four or five days in each month. Over the years he had seen various ENT specialists in Changsha, Wuhan, and Beijing without obtaining relief. I could also see from his medical history that he had visited many of the better-known Chinese medicine physicians in the area, and had been prescribed modifications of the formulas daochisan, xiehuangsan, and shengmaisan, as well as precious medicinals and patent formulas such as xiongdan, niuhuang, zhongtongan, zhenhuangpian, etc. At various points he had been instructed to eat simple and mild-tasting foods, and to scrupulously avoid spicy or stimulating dishes. Although he followed these recommendations to the letter, the sores would still erupt, and the pain and discomfort never ceased.
With the exception of this issue he was generally healthy and active and his bowel movements were regular. Besides having urine that was more yellow than normal, he reported no other symptoms. His tongue was pale, and his pulse was small and wiry. I prescribed a modified ganluyin:
shenghuangdi (dosages deleted)
Second Visit: October 13
After finishing seven doses of the prescription the patient’s sores had not healed and were still painful, and the patient had a sense that they were actually getting worse. I looked carefully at his tongue and noted three or four small ulcers distributed over both sides of the tongue. His tongue was fat (swollen) and pale, with tooth marks and a thin white coating. His pulse was small and wiry.
I changed the prescription to a modified mahuangfuzixixintang:
mahuang (dosages deleted)
Third Visit: October 18
The patient had come early as he was about to leave on a business trip, and at the time of the visit he had not yet finished all seven doses of the prescription. He told me that by the time he had finished the second dose the pain had already gone, and by the fifth dose, which he had just taken, the ulcers had already healed.
I observed that his tongue was much thinner (less swollen) than before, and it was still pale with a thin white coating. His pulse was thin and wiry. The patient also mentioned that every since he started getting oral ulcers he had also developed small lumps on his scalp, which were reddish and sensitive to pressure. This was in spite of having taken so many cold and cooling herbal prescriptions in the past.
I re-prescribed seven doses of the decoction, and additionally prescribed the same formula in pill form for him to take on his trip:
mahuang (dosages deleted)
(the pill prescription was to be taken twice a day, 6g each time)
Fourth Visit: November 22
The previous prescription had lasted about a month, and the patient came back in as he was running low. He said that in the last month he had not had a single ulcer appear, and in addition the lumps on his scalp had gotten much smaller.
There was no need to change an effective formula like this, so I prescribed another month’s worth of pills to consolidate the treatment.
Fifth Visit: March 11, 2013
After finishing the previous prescription the patient had not had any more oral ulcers, and the lumps on his scalp had disappeared. I observed that his tongue was still pale and had tooth marks. I added 30 grams of xianlingpi to the formula, and re-prescribed another month’s worth of pills.
Lessons learned from this case
Generally speaking, oral ulcers are usually associated with a pattern of yin deficiency with damp heat. It is extremely rare to see them occur in a pattern of yang deficiency with cold damp. This was one of those rare cases.
In the initial visit, although I noted that the patient’s tongue was pale with a thin white coat (in contrast to the usual red tongue with yellow coating of most oral ulcer sufferers), I still did not feel confident about using warm medicinals. It was quite possible that these signs of cold resulted from taking so many cold and cooling medicinals, rather than being a true sign of internal cold, so I was concerned about the possibility of adding fuel to a fire. The initial use of ganluyin was a way of testing the waters, and when it became obvious in the second visit that not only had the patient not improved, but even seemed to be getting worse, and now had a fat (swollen) tongue, I felt more confident about turning to warming methods, and prescribed mahuangfuzixixintang to warm the channels and disperse cold. Added to the formula were banxia to transform phlegm, fuling to leach out dampness, and ganjiang to warm the center. I was still concerned that this sudden change to warm herbs might cause lurking fire to float upwards, so I also added erhuanshihu to nourish stomach yin, and renzhongbai to clear deficiency fire from the middle burner. This approach turned out to be the right one.
One of the factors that prompted me to re-write the formula from scratch was an offhand comment by the patient: “As soon as I see my tongue getting fat, and as soon as those tooth marks appear, I know things are going to get worse.” As the old saying goes, “Patients are our teachers”! If he hadn’t mentioned this information I might not have had the temerity to use such warm and hot medicinals!
This is a book I've enjoyed for many years - I'm excited to see it come out in English!
The Classic of Supporting Life with Acupuncture and Moxibustion Vol. I-III
Lorraine Wilcox (Editor) Yue Lu (Translator)
Reviewed by Henry Buchtel
Wang Zhizhong was a man full of contradictions. On the outside a moderately successful teacher of Confucian learning, in his later years he gained renown instead for his private study and practice of the art of medicine. His text《針灸資生經》Zhenjiu Zisheng Jing contains the results of his studies – page after page devoted to resolving age-old discrepancies in the recorded locations of traditional acupoints, and passage after passage recording his own clinical experience in locating the most effective acupoints for specific patients at the time he treated them. Why then, when his own experiences with patients showed that the exact location of an acupoint could be found through palpation, did he still devote so much effort to recording and standardising the location of named acupoints? This is the question that I brought to this new and exceptionally accessible English translation of the Zhenjiu Zisheng Jing: The Classic of Supporting Life with Acupuncture and Moxibustion (Volumes I to III).
In this day and age, where textbooks feature descriptions of the locations and routes of acupoints and channels as if they were incontrovertible fact, it is easy to assume that these areas and connections have always been agreed upon, and that there is no disagreement among the various authoritative texts. This was by no means assumed to be true by Wang Zhizhong, as can be seen in Volume I. Here he lays out the result of his efforts to reconcile the different standards for acupoint location and cun measurement methods, and sets out a single standard for both. His influence on later generations can be seen when it comes to the location of abdominal points, where his chosen standard of 1.5 cun (measured using the distance between the creases of the middle finger as one cun) between the Kidney, Stomach, and Liver channels on the abdomen was used by texts for the next half-millennium, including such classics as the Zhenjiu Dacheng, (Great Compendium of Acupuncture and Moxibustion). However, Wang Zhizhong made no effort to conceal evidence of any discrepancies between his sources, and in fact took great care to leave behind a record of his thought process and the names of the texts to which he referred. This takes us to Volume II, where in this careful translation written in natural and idiomatic English, we find an unusual treat – more than a dozen of Wang Zhizhong’s personal essays on matters relating to moxibustion, acupuncture, herbs and the art of healing. For example: ‘Qian Jin Yao Fang says: There are old and young people, with tall and short bodies, fat and thin skin. So we need to consider this thoroughly and discuss it, and be precise when locating points. [Points are located] in the muscles, in the cleft of the joints, or in depressions. Patients feel happy when we press these points. If we locate the points carefully, peacefully, and serenely, we can find them [accurately]., (2.08 Locating points)
Such essays are a rarity among medical classics, which tend to be written in more of a distant and authoritative voice. However, as smooth and easy to read as this English translation is, one must still remember that Chinese texts of that time were not meant to be quickly devoured like the latest bestseller in the airport bookstore. As Wang writes, this material is to be ‘… considered thoroughly and discussed.’ These passages lend themselves to being mulled over, deliberated upon and perhaps committed to memory in the same way one might appreciate poetry.
In a text like this that has been passed down for nearly a thousand years, it is rare for the complete text to have found its way to us unharmed. Even though I accept this, I still feel that it is a terrible loss to us that the last three of Wang’s personal essays did not survive. One of the three, titled ‘Zhenjiu Shou Bing Chu’ (‘Areas affected by disease in acupuncture and moxibustion’) might have helped us address the seeming contradiction that runs throughout his writing – the fact that Wang both palpated for areas of soreness to determine where to needle, and at the same time obviously placed great importance on determining the standard body-cun location of acupoints.
In Volume III (as well as the forthcoming Volumes IV-VI) we find another unique aspect of the book: a listing of acupoints by disease with personal commentary. The phrase ‘area affected by disease’, or variations such as ‘[an area that] aches when pressed’, appear in Wang’s clinical commentary several times: ‘We should apply this moxibustion on the bony prominence that aches when pressed’ (Chapter 3.29, Bloody stool), ‘I pressed her Da Chang Shu and she felt sharp pain’ (3.33, Intestinal pain). The use of palpation to precisely locate effective acupoints, or to help determine whether or not to use a documented acupoint, is one of a great many traditional techniques that did not make their way into modern TCM textbooks in China or the West, a situation which has affected the way acupuncture and moxibustion is practised today. The situation in modern China was described by contemporary Chinese medical scholar Wei Jia (魏 稼) as follows: ‘For a long time we have emphasized the clinical application of static points [i.e. acupoints with names and fixed locations], while deep and broad exploration of dynamic points [i.e. acupoints that have no fixed name, location, or number and are often in a hidden or mobile state, requiring special diagnostic techniques to identify] has not elicited enough attention. [Changing this] will improve clinical results, and help to develop or even reconstruct acupuncture theory.’ ('动穴疗效钩玄'魏 稼 中医药通报 2008年 第7卷 第1期). It is exciting to think of the role that the publication of this translation might play in the continuing emergence of this hidden side of the medicine, and the influence it might have on future editions of college textbooks.
I do not feel that in my reading of this text I was able to reconcile the deeper conceptual contradiction between the apparent existence of both static and dynamic points – one existing irrespective of individual or disease, and the other identifiable only in the moment. However, we can find a hint of justification for the efforts Wang took in standardising and recording acupoint locations in heartfelt quotes such as ‘If [he] had burned three or five hundred cones of moxibustion [as recorded in Tong Ren Shu Xue Zhen Jiu Tu Jing], the patient might have lived a long time, too.’ (p.76); or ‘Note that Su Wen – Ci Jin says: The patient will become limp if the patella is punctured and fluid comes out. Du Bi (ST 35) is located below the patella, on the shin bone. The acupuncturist must not disparage this.’ (p.134); and ‘I have saved more than a hundred people already’ (p.271). Lines such as these make it quite clear that Wang Zhizhong recognised the importance of transmitting and passing on the clinical pearls of his predecessors. One might say that Wang accepted that the process of naming and recording the location of acupoints, using the fairly consistent and accurate body-cun method, was the best way possible to pass on knowledge in a textual form – and this was valuable enough in and of itself to justify his efforts.
This English translation, authored by Yue Lu and edited by Lorraine Wilcox, is published complete with the original Chinese, acupoint illustrations and a detailed table of contents and indices. Nearly one millennium after it was first published, in this text we are given access to a lifetime of scholarly and clinical experience in moxibustion, acupuncture and herbs.
Published in The Journal of Chinese Medicine, issue no. 106
At The Scene
In the middle of the street
Lies a pile of broken glass
There is no need to guess
What just occurred
This time, someone finished their drink
And smashed the empty bottle on the ground
A car, driving by
The glass gives off a shimmer
Of sound, delighting the ears
From the collection Qiutian Shi Mozhong Sixiang Peizhe Wo, by Liu Jianhua, published in Chinese by Zhuhai Publishing Co., 2012.
Translated here by Henry Buchtel, with help from Brodie Burris
I'm reminded of the passage in 《養生論》where it talks about the power of emotions, in particular this line：“夜分而坐，則低迷思寐；內懷段憂，則達旦不瞑。” (loose translation: if one stays up late to work, he will feel quite sleepy; but if one's breast is full of worries, his eyes will be open all night)
In my case what it takes is a stimulating lecture and good conversation!
As I was helping to interpret for the Q&A sessions at the workshop this morning, I had time to carefully go over the powerpoint presentations before the workshop. Of the four presentations, the one that really caught my attention was delivered by Jing Xianghong of the Chinese Academy of Chinese Medical Science.
She took us from laboratory research - experimentation with epilepsy rat models - to a clinical study on patients suffering from severe epilepsy, and during the Q&A session mentioned that her hospital is currently using their new technique as an alternative to invasive VNS device implantation.
The starting point was an explanation of how vagus nerve stimulation (VNS) is able to reduce the frequency or severity of epileptic seizures through direct electrical stimulation of the vagus nerve. She then explained that, like most other cranial nerves, there are no surface areas of the torso that are innervated by the vagus nerve. However, there is an auricular branch of the vagus nerve (the ABVN), which can be stimulated through the skin in the external auditory canal (and, apparently, the auricular concha - the area of the ear associated with the internal organs in the 'inverted fetus' microcosm image).
From this, Prof. Jing presented their epilepsy rat model showing that electrical stimulation of this area of the ear was effective in controlling epileptic discharge. With this evidence, they went ahead with a 50 subject clinical pilot study where the patients, all of whom suffered from refractory (i.e. not controlled by medication) seizures, had the area of the ear innervated by the vagus nerve stimulated using a small electronic device. This stimulation was done twice a day for 30 minutes each time, and was able to bring about a significant clinical effect in controlling their seizures. (it was more complicated than that, but I don't want to go into that here...)
Next was a larger study with 144 patients that also showed a significant effect.
One of the audience members asked if she had done a direct comparison between this auricular stimulation and conventional VNS, and Prof. Jing responded that they had not compared these two directly, but that in her hospital in Beijing they now use this device in an experimental fashion for every patient who has been referred for VNS device implantation, and that many patients were able to become seizure-free just by doing this external stimulation twice a day, and were thus able to avoid an expensive and potentially risky operation.
A great example of translational (ie from 'bench' to 'bed') research!
Tomorrow morning the pre-conference workshops for the 2013 SAR conference here in Ann Arbor will begin! I've been waiting for this conference for a while and am excited to see it finally roll around.
In order to reflect on the talks and share interesting developments, I've decided to post summaries and comments as frequently as I can during the next four days. There are two workshops tomorrow morning, and I will be at #2 "Challenges of Acupuncture Clinical Research in China." I certainly found doing acupuncture research in China challenging (though perhaps for different reasons than the workshop panelists ;P ), so I'm looking forward to hearing some new perspectives on it.
Even though acupuncture research is a fairly obscure field, there are several 'household names' giving talks in the next couple days, some of which are also personal heroes of mine. I just hope I can keep up with everything without getting burnt out!
Minor epiphany this morning while playing Taiji: "Walking backward along a circular trail" is a much better description of life than "Marching forward", "The forward march of progress" etc.
My Taiji practice consists of repeating one move while slowly moving along a trail in the woods, and the easterly wind and snow was so strong this morning that I decided to start off walking backwards along the trail to keep the snow out of my face. Watching my footprints extend out in front of me put me in mind of history, while looking to the left and right to get my bearings, and occasionally walking off the trail or stumbling over roots and stumps, made me think of how we can only guess at the future by comparing our present point in history with what we know of the 'circular trail'.
There are many observable and reliable cycles: the rising and falling of the sun, the waxing and waning of the moon, the changes of the seasons...we don't really know what will happen next, but by becoming familiar with these circular trails, and knowing our present position in it, we are able to accurately predict and prepare for what will happen next.
There are many other cycles that are perhaps less directly observable and more contentious, such as 'the rise and fall of civilizations', the natural fluctuation of the economy, etc.
The trail analogy could be extended by talking about the trail representing the range of variables that represent our comfort zone or healthy zone, as in temperature, diet, labor and sleep, etc. As I looked back on my footprints I could see where I had not been able to predict the turnings of the trail and walked into a bush (ouch!). We can look to the past to inform us of our limits, and the consequences of going outside them. At the same time we can take steps to ensure that the trail is even more comfortable, by taking care of the trail as we walk along it (removing fallen branches, trimming the bushes on either side, even putting down flagstones...).
It would seem that many insights could be gained by walking backwards along a circular trail every day!
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