(un)Learning Anatomy

WHEW! okay, a quick game of catch-up!

Acupuncturists stick tiny needles into acupuncture points (xue), which lie on the meridians, through which Qi flows in order to influence an Organ in a person's body.

What follows is a brief discussion on the TCM anatomy: Qi, meridians, Organs.

No one English word can capture the meaning and nuances of the word Qi. Everything in the universe, organic and inorganic, past and present (and future), is both composed of and defined by its Qi. In his famous book, "The Web That Has No Weaver," Ted Kaptchuck writes, "Qi is not so much a force added to lifeless matter but the state of being of any phenomena... Qi is the pulsation of the cosmos itself." Here we see a difference between the general Darwinian belief that consciousness is the epitome of evolution; a recent development that is bestowed only to the highest evolved creatures; us. But in traditional perspectives; Indian and Chinese included, energy with intention or consciousness of some kind is the basis for the universe, the most elemental aspect in the world as we know it (rather than the atom).

One of the keys of understanding TCM is understanding that the most general interpretation of Qi is by no means the only use of the word. While everything is composed of Qi and everything is connected by Qi, it is also important to take the leap (that I dread) to separating and identifying the various Qis in order to apply the concept to the complex world of healing. The sun has its own Qi, the Earth its own, Water its own, and Wood and Metal their own Qi as well. And just as the universe is made up of these elements, the human body is composed also of these elements and so we, too, have these various Qis within us. In this context however, they are given slightly different names:

Heart Qi (Fire)

Spleen Qi (Earth)

Kidney Qi (Water)

Liver Qi (Wood)

Lung Qi (Metal)

Just as Qi refers not to an entity or a form but to an energy, so too the organ system in TCM is not so concerned with the physical anatomy, or form. This can be dumbfounding for someone grounded in a Newtonian reality, and understandably so. In TCM physiology, each organ (with capital letters) is associated with its meridian (the pathway of Qi), and so represents not just the organ but a whole aspect of human function. In contrast to the Western-scientific medical paradigm, TCM diagnoses and treats (pattern identification, or bian-zheng) based on the energy of symptoms. TCM doctors speak of deficient Spleen Qi, Excessive Kidney Yang, or Heart-Yang rising. These are diagnoses (really called patterns!). But they are also the key to treatment. If you know that your Spleen Qi is deficient, well from there, its easy, you just need to tonify your Spleen Qi, and there are acupuncture points and herbs that do just that. Contrast this with the diagnosis of "functional hypothalmic amennorhoea." I was given this diagnosis last spring, and thankfully, because I know a thing or two about the body, I could parse this out to mean "we (the men in the white coats) don't know why (the "functional" part) your hypothalmus (an endocrine gland of which we also know minuscule amounts) is not operating correctly, causing your menstruation to cease." I was told to take calcium supplements to keep from developing osteoporosis. "Gee... thanks!" Here we see how a diagnosis in the Western medical paradigm can indeed be a dead end (please excuse the pun).

This kind of diagnosis by renaming- diagnosis by translating your symptoms into a dead language (usually latin i.e. laryngitis: inflamed throat, arthritis inflamed joints, eczema; boils/eruptions), serves only to disempower the patient.

Rudolph Ballentine (it may be fair to call him my best friend at this point) writes:

"This re-labeling communicates to the patient not information or insight, but rather the message "you are not in charge of this situation." Renaming is, in effect a ritual use of words. It formalizes a specific kind of relationship between the doctor and the patient. In an almost magical way, it transforms the doctor into the knower and doer, and the patient into the more passive receiver. By pronouncing mysterious medical words, the doctor asserts his knowledge, power, and dominion. If the patient accepts the complementary role, a sort of hypnotism might ensure: "By virtue of this ritual, you are now in control, Doctor. I am a helpless and passive recipient of your powerful interventions. By using a term that is not of my world, you have removed this transaction from the realm of what is knowable to me. I will accept your recommendations unquestioningly. If I were to show doubt or reservations, you would be justified in being indignant for I would have violated this covenant that we are now agreeing upon.""

(can you see why Ballentine in my best friend?)

So next time you go to your doctor with a sore throat and he says you have pharyngitis (or laryngitis), you can tell him/her: "I know, I just told you that

Let's look back at the TCM version of diagnosis-treatment, or pattern identification. As we said, TCM doctors don't spend much time externalizing; that is, they don't try to point a finger at a single causal entity, rather they embrace the whole picture of a person, find the pattern that fits and, follow the map drawn by that pattern back into harmony. This is sort of a glimmer of the yin-yang notion that within the yang is the seed of the yin, within the yin is the seed of the yang: within illness is the seed of health. Thus, "the lines of causality are bent into circles." (Kaptchuck, 144) Chinese medicine "never leaves the realm of signs and symptoms," to seek an externalized disease entity beyond reach not only to patients but also to many physicians ("you have syndrome x, there's nothing we can do.") "During the course of [examination], the physician simultaneously collects, interprets, and organizes signs- a complex, subtle perception that leads to an understanding of the physiological (and energetic) events taking place in the patient's body." Here, however, the physiology that the Chinese physician is examining is a bit different from the physiology of the Western medical system, and the outcome is drastically different. While the Western diagnosis may or may not lead to a treatment, the TCM approach to diagnosis is inseparable from the treatment- it is the roadmap from imbalance to harmony.

Kaptchuck writes, "The "cause" ... is not treated. Instead, the physician treats the approximate pattern generated at the moment by the particular configuration of manifesting signs. There is no "diagnosis," only the patient-physician encounter and therapeutic response."

This is how "functional hypothalmic amennorhoea" becomes "Deficient Spleen Qi." But even here we lose things in translation, as what is normally translated as Spleen, encompasses digestive capacity, blood production, thoughtfulness and ability to concentrate, transformation and transportation, muscle tone, and the root of Qi. You can see how "Spleen" (even with a capital S) doesn't quite communicate that to the Western-newtonian mind, especially considering the fact that Western medicine doesn't actually give much attention to the spleen (little s). Pattern thinking also helps to connect symptoms that in Western medicine would each receive their own diagnoses, and probably their own pills to boot: we can look at my own pattern where "functional hypothalmic amennorhoea," insomnia, history of anorexia nervosa and continuing poor appetite- is included in "Deficient Spleen Qi." And all of a sudden, I can breathe, it seems manageable, and not  only that, but I am gaining tools and understanding to heal myself. What is even cooler than all of this, is the fact that at the clinic where I am shadowing a TCM doctor and acupuncturist (another post on this later because it is WAY cool) they sell acupuncture needles. They sell acupuncture needles to the patients. This means that they are essentially encouraging patients to treat themselves (and they're cheap!). This is an empowering (self-)healing paradigm with the language of diagnosis and treatment methodology to match.

(oh yeah, and after two weeks on Chinese herbs to "tonify my Spleen Qi," I am sleeping better, and have resolved my amennorhoea.)

Happy New Year (to all of you who celebrate the circumcision of Christ)!

**Look out for a post sometime soon on resonance and the acupuncture clinic!