My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The perspective I like to come from when working with the Primary Channels is a progression theory, as is presented in Chapter 10 of the Ling Shu. The Primary Channels are part of the greater acupuncture channel system structure. They are one of six channel systems. Yet, the Primary Channels are structured to tell the story of all the channel systems in general. They are like the big picture of the body.
If we view the Primary Channels as a story of progression - that of physiology as well as pathology, the 12 channels paint a picture filled with meaning. This is a viewpoint that can differ from the TCM or Five Element Zang Fu (organ energetics) systems. We can view pathology in the Primary Channels as beginning from two main sources: from the exterior and interior of the body.
The Primary Channels are structured to tell the story of all the channel systems in general. They are like the big picture of the body.
It is interesting to note that the Ling Shu presents more than one image of the flow of the acupuncture channels. There is the depiction presented in Chapter 10, where the Lung channel begins interiorly at the center of the Stomach before externalizing and traveling to the thumb. There is another presented in Chapter 5, which describes the channels beginning at the digits of the hands and feet, traveling to the midline of the body where they "terminate."
These two descriptions of the Primary Channels are necessary. They arguably suggest that pathology in the body can emerge from outside the body or from within. Problems can result from a dysfunction in physiology or from the invasion of external forces. The notion of energetic levels or "layers" in the body is important to Chinese medicine. We learn this to be true from the Shang Han Lun as well as Wen Bing schools. However this concept is also present in the discussion of the Primary Channels.
The concept of "levels" of energetics is the main teaching of the acupuncture channel systems in general. The Su Wen introduces this concept in Chapter 63. This chapter describes how pathology penetrates from the most surface level of the body - the skin and sinews, through the various "collateral" systems: the Sinew channels and Luo Vessels, before finding its way into the Primary Channels and eventually the Zang Fu (viscera and bowel organs). Therefore, each Primary Channel within the progression represents a deeper layer of energetics in the body, progressing from the Lungs all the way to the Liver. Therefore, within the Ling Shu point of view, to work with the Lung Primary Channel is working with the most superficial energetic level of the body. The Liver is, therefore, the deepest within the Primary Channels. Within this model, superficial issues would be best treated with the early Primary Channels within the sequence. The later channels are reserved for very deep, severe issues.
It's important to use the channel or channel system that resonates with the energetic depth of the condition being treated. This is akin to locating and matching the level of vibration in which a patient is resonating: talking to a person "where they are," rather than where you'd like them to be. To work either too superficial or too deeply could potentially cause failure to communicate altogether, or it could even make the problem worse by drawing it deeper into the body.
The Lung and Large Intestine Primary Channels are the domain of Wei (defensive) Qi as it relates to the external aspect of the body. Pathologically, these channels represent external challenges to the body, medically called "wind-cold" and its transformation into the complications of "wind-heat" and "wind-damp." The Lungs intrinsically protect the body from the exterior world, allowing it to release pathogens via the mechanisms of sweating and urination. When the body cannot "release" something, resistance and friction is created which creates heat or dampness. This becomes the level of the Large Intestine: resistance that creates more dramatic symptoms. If you look at Chapter 10 of the Ling Shu in terms of symptoms, you can begin to piece together the progression theory of the Primary Channels.
"Wind-cold" (or its mutation into wind-heat or wind-damp) as it moves into the Stomach Primary Channel represents an exterior pathogen as it transforms into internal heat. At the level of the Stomach, the mechanism for the production of qi, blood and fluids becomes damaged. However, it is not until the condition progresses into the Spleen and Heart that deficiencies (of qi, blood and fluids) begin to emerge.
Heat is seen as the pathology of the interior of the body. It can be created via internal causes such as the emotions, or from the progression of external pathology that has found its way into the interior of the body. From the Stomach, heat can travel elsewhere in the body. When pathogenic heat moves from the Stomach into the Spleen and Heart, it can damage the functions of these channels, impairing transformation and transportation, as well as blood circulation. At the levels of the Spleen and Heart, there is also an effect on the mind and spirit, as the Spleen and Heart "store" the Yi-mental capacity as well as the Shen-spirit affect.
Looking at the Primary Channel sequence as a progression theory, we can develop a very succinct way of orienting our acupuncture treatments. Like the Shang Han Lun orientation, this theory helps us orient where a patient is residing in their condition. Ideally, it helps us go directly to the level where the disease is located. It can also give us clues as to where the problem originated, and therefore where we need to "bring it back to" in order for healing to occur. This follows the theory of working with "wind" ("the "origin of the 100 diseases"), as taught by the Su Wen. We must start where the problem has progressed into - the current moment - and return it back to where it has originated.
The method of working with "wind" is arguably a Confucian "humanistic" way of treating. The Ling Shu is highly influenced by Confucian philosophy. Important within Confucianism is the process of learning. To the Confucians, the highest good in life is to become fully aware of our own intrinsic humanity. The Primary Channels are representations of how we take what is intrinsic - our basic potential for "goodness" and bring it into action via our lives. This theme is established early on within the depiction of the Lung channel, as it moves from the "center of the stomach" out into the arms.
The Primary Channels show how we contend with the external world, react to it, allow it to change us, and more fully activate our innate "goodness." It is at the level of the Spleen and Heart that we first begin to "rectify" our qi (actions) and blood (thoughts). These levels process that which we have been confronted with from the external world (the level of the Lungs) or the internal world (the Stomach). Within the mid-level Primary Channels, energy is brought very deep into the body, through the Small Intestine into the level of the Constitution (Bladder and Kidney). There is an orientation of our sense of reality that occurs in the level of the Pericardium and Triple Heater, which comes to form our way of seeing the world (our Marrow): the levels of Gallbladder and Liver. Philosophically, this recreates our life, as our outer reality comes to reflect that of our inner world.
It is interesting to note that the upper sense organs don't get activated until the level of the Stomach's Primary Channel. The Large Intestine connects with the mouth and the nose, however it is not until the Stomach that the eyes and ears become activated. The Stomach, therefore, becomes the first Primary Channel of interest when looking at perception. The Stomach is often said to be the Primary Channel that activates all of the upper sensory organs. In fact, its "Source" point, ST-42 Chong Yang is said by Li Dong Yuan to be that which "activates" the "pure yang" of the Stomach to the upper sensory organs. The term "pure yang" connotes perceptive capacity. There is a relationship created between the Stomach, the Extraordinary Vessel Chong Mai (the Sea of blood and the 12 Primary Channels) and "Yang."
The term Chong, included in the acupuncture point ST-30 Qi Chong as well as in ST-42 suggests the importance of the Stomach Primary Channel in bringing the energetics of Chong Mai (the "blueprint" of the body) into both the digestive system (ST-30 is considered a Shu-transportation point for the "Sea of Food and Drink" by the Ling Shu) as well as into the upper sensory organs (according to Li Dong Yuan's description of ST-42).
Therefore, when pathology reaches the level of the Stomach, function of the digestive system as well as that of the sensory organs become affected. However, pathology can also start at the level of the Stomach. The Stomach Primary Channel's connection to ST-30 and ST-42 can be seen as the way the constitution circulates its energetics into the post-natal level. There's a reason the Earth element is often placed in the center of the Five Element orientation.
To work with issues that originate from the interior of the body, namely the emotions, the Stomach is the primary focus. Obviously, the emotions will effect all the other organs of the body, especially those that relate to the blood. However, the Stomach is seen as the origin of blood: it is the chief organ involved in the production of blood. Blood is the mediumship for the Shen. Therefore the Stomach is even more primary when working with the emotions than the Heart and Pericardium, which circulate the blood, yet don't necessarily produce it.
To the Confucians, when working with the emotions, the most important consideration is the strength of the mind. Emotional issues are rooted in "improper thinking." Therefore the Yi, associated with the Stomach and Spleen is fundamental to working with the emotions. From a Five Element perspective, it is the Earth that creates boundaries for the Water (the constitutional self). This means the Spleen and Stomach, via the mind, is that which controls a person's original nature and its emotional expression. The Earth, through its sensory capacity and ability to transform and transport all phenomenon, constructs a manageable reality for the constitution to express itself. Obviously, the management of the Water element via the Earth can be problematic at times, stagnating the Water, creating turbidity, muddiness, confusion, hypersensitivity or hyperactivity.
The Stomach Primary Channel teaches us that to work with pathology involving the emotions, it is often necessary to address the sensory orifices. However, within the Primary Channel sequence, it is the Yang Channels which follow the Stomach Primary Channel that appear to have a stronger effect on the sensory orifices: especially the Small Intestine and Triple Heater Primary Channels. Part Two of this article will explore the energetics of these two Primary Channels in relation to perception, pathology and the sensory orifices.
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