Chinese Medicine and different approaches to Autoimmune diseases

Definition of autoimmune diseases

Autoimmune diseases are diseases where immune response is attacking ones own organs or tissues. It can affect small area or make itself known throughout the whole body. There are at least three classes of autoimmune diseases that are based on different immunological factors.
First class is cytotoxic hypersensitivity where antibodies bind to ones own cell surfaces and are recognized as the enemy. This can happen for example because foreign chemicals or antibodies bind to cells. This class can include autoimmune diseases born after infections, environmental exposure to chemicals, medicines or injected antibodies like with vaccines.
Second class contains autoimmune diseases where minimal immune complexes cannot be cleared by macrophages and they travel into cell walls. Common areas of deposit of these antibodies are joints, walls of veins and skin. This class include systemic lupus erythematosus (SLE) and autoimmune response triggered by mold.
Third class is cell mediated immune reaction where helper T cells and monocytes or macrophages try to defend against intracellular pathogens. This kind of immune reaction is normal reaction to mycobacteria, fungi and some parasites. This can also happen with tumors. When this becomes autoimmune reaction this can form diseases like Celiacic disease, Crohn’s disease and psoriasis.
Some autoimmune diseases can be combinations of above and some common autoimmune diseases like Sjögren’s syndrome and spondyloarthropathy do not even fit to any of these categories.
Medical research is finding that many common diseases could in fact be autoimmune diseases. The current list of suspected autoimmune diseases is much longer than list of accepted autoimmune diseases.
The causes of autoimmune diseases are being debated. Commonly it is accepted that some forms have genetic tendency/risk like rheumatoid arthritis, psoriases and diabetes mellitus juvenilis. Some are triggered by environmental factors like toxins or even by medication or vaccinations. Stress seems to be main trigger for some diseases like multiple sclerosis, Addison’s disease, Sjögren’s syndrome and spondyloarthropathy.
The treatment to these diseases by Western Medicine is basically suppressing the immune system. This is usually done by medications and rarely with surgery like thymectomy in myasthenia gravis. Western medicine is quite powerless to do anything, except momentarily easing the symptoms.
View of modern Chinese medicine is quite similar to Western medicine when it comes to autoimmune disease. It concentrates on using modern science to break down the causes and to track down the underlaying root of the problem to cellular level. The treatments are sometimes based on herbal medicine that are selected either from long history of use for similar symptoms or more recent research of biologically active molecules found from plants. Acupuncture and moxibustion are mostly used for symptoms like pain.

Traditional Chinese medicine and autoimmune disease

In ancient text there seems to be accounts of rheumatoid arthritis, inflammatory bowel disease like Crohn’s disease and ulcerative colitis and many other autoimmune diseases. In most cases presented in classics we cannot possibly know what the disease truly was. From short list of symptoms we do not know if the disease was for example lyme borreleosis or multiple sclerosis, or was it non-autoimmune form of arthritis or rheumatic one. What we know is some of the methods diagnose and treat. And in some cases we even know the results… if we can trust our sources.

Traditional Chinese medicine still relies old form of diagnosis done by looking, asking, listening, smelling and taking pulse. The diseases are then differentiated using for example eight principles and Zangfu-theory. The diagnosis and treatment will depend on school and expertise of the practitioner. The most commonly used diagnostics and treatments are based on Zangfu, Five phases, Bi&Wei-syndromes and Wind-syndromes. One of the best books with this approach is Treating Autoimmune Disease With Chinese Medicine written by Wanzhu Hou, Guangpi Xu and Hanjie Wang (ISBN 978-0-443-06974-1).
To illustrate this approach we take an example from the book. According the authors the aetiology and pathology of Systemic lupus erythematosus can be presents to be caused by one or all of the following:

  • Deficiency of Yin as the internal cause of lupus
  • Invasion of pathogenic factors as the external cause of SLE
  • Blood stasis, Phlegm and Fluid are pathogenic substances, as well as one cause of SLE, and an aggravating factor in existing SLE

The Systemic lupus erythematosus can be differentiated by symptoms to following main categories:

  • Domination of Heat-toxin
  • Internal Heat due to Yin deficiency
  • Blood stasis and Heat stagnation
  • Spleen and Kidney Qi deficiency
  • Fluid retention due to Yang deficiency

The book prescribes different points and herbs for possible treatment and includes couple of case studies.
In light of element theory most of the autoimmune diseases have characteristics of various degrees of Yin deficiency, heat and phlegm (turbid dampness). This approach works greatly to relieve the symptoms and sometimes this can provide a cure for disease itself. In many cases of autoimmune diseases this approach only works to relieve the symptoms. In many cases this relieving symptoms is already very great achievement. For example in multiple sclerosis the myelin is destroyed in relapse phases and if this relapse can be shorten or stopped the amount of damage to nervous system is minimized and the body has time to recover during remissions. This can slow down or even stop the advancement of multiple sclerosis and at least the symptoms during the relapse are eased.

Explaining autoimmune disease with Shānghán lùn by Zhāng Zhòngjǐng

张仲景 - Zhāng Zhòngjǐng (150 — 219)

张仲景 – Zhāng Zhòngjǐng (150 — 219)

The classics like Shānghán lùn (Treatise on cold damage), Sùwèn and Língshū are more concentrated on our energetic structures and their reson

ance with cosmic forces than classification of symptoms to elementary correspondences. These classics describe how the pathogenic factors travel in our systems and how the diseases patterns develop and change. These theories, especially Shānghán lùn theory, are usually used to

explain acute diseases with emphasis of cold pathogen. The energetic structures and possible ways the disease may develop apply also to other diseases.

In chapter 6 the Sùwèn explains how the three Yang and three Yin together make six continuous looping channels. The 31th chapter explains how a cold disease develops and travels through this channel system. The Shānghán lùn uses this six channel theory from Sùwèn and explains symptoms and principles of healing in much greater depth. The depth of the six channels are, from superficial to deeper, Tàiyáng (small intestine and bladder channels) → Shǎoyáng (sānjiāo and gallbladder channels) → Yángmíng (large intestine and stomach channels)→ Tàiyīn (lung and spleen channels) → Juéyīn (xīnbāo and liver channels) → Shǎoyīn (heart and kidney channels). The disease progresses through these levels usually in different order. The primary order of progression in Shānghán lùn is Tàiyáng → Shǎoyáng → Yángmíng → Tàiyīn → Shǎoyīn → Juéyīn (1) . After getting to Juéyīn the disease may even result in death. The difference between the depths and progression order is due channel pathways. The disease advances from Tàiyáng to foot portition of Shǎoyīn (kidney meridian). From kidney meridian it travels to Juéyīn ending up to Xīnbāo – or hand/yang portion of Juéyīn. In English literature the Xīnbāo is commonly translated as Heart protector or Pericardium. Xīnbāo is intimately connected to the Heart and true Heart-channel. We have to remember that what is commonly called as the Heart-channel is in fact only a superficial branch of the true Heart meridian. The real Heart-channel lies deep with and cannot be pierced and have no points on it. This is also the reason why the Heart channel is not mentioned in oldest of texts and why the Xīnbāo-channel was sometimes called the Heart-channel. It is said that if the pathogens could get into True Heart-channel the Shén or spirit would leave and death would follow. So the True Heart channel is protected by Xīnbāo.

In regards of autoimmune diseases these theories of depth and progressions provide few very interesting points. The Shǎoyáng (Sānjiāo and gallbladder) is the axis of all Yang channels. Diseases in this level are considered to be in between states. They are not fully internal nor external. They have characteristics of moving and changing. They can manifest as shaking, chills, intermittent fevers, uncomfortable breathing and constantly changing pains. Gallbladder channel is responsible of peripheral nervous system and is connected also to Marrow. Marrow in Chinese medicine also includes spinal cord and brain. The master or meeting point of all Marrows lays in gallbladder channel (GB 39). Sānjiāo connects the brain to the three Dantian. It is also deeply connected to harmonious working of all endocrine glands which control the hormonal balance of body. Shǎoyáng is the harmonizing axis of all Yang channels that are responsible of all activity of body
The Juéyīn is more connected to the Liver, Detoxification, Blood, tissues, body and form. The Xīnbāo portion is also connected to thymus responsible for “educating” the T-Cells which plays key part in adaptation of immune system. It is the utmost Yin. If this level gets affected the Yin becomes disharmonious and cannot transform to Yang. This can cause deformity and dysfunction of tissues. In more serious level the separation of Yin and Yang can happen, meaning death.
The autoimmune disease can be seen as breaking of this fundamental harmony. In classics these states are seen as result of diseases that were not fully healed. In Western medicine it is also accepted that certain prolonged diseases can trigger autoimmune response. And even improper use of medicals (like antibiotics) can cause autoimmune diseases like Crohn’s disease (2).
This theory also applies to other diseases arising from foreign chemical entering the body. Recently in Finland there has been cases of narcolepsy caused by swine flu vaccinations(3). Even though the narcolepsy is not considered autoimmune disease the cases seem very similar in the eyes of Chinese medicine diagnostics as the Shǎoyáng is responsible for harmonizing the activities of Yang channels. The Sānjiāo and Gallbladder channels are often used to treat diseases of brains and more generally the whole nervous system. The points from gallbladder (ie. GB38) and Xīnbāo (ie. XB8-9) channels are used for example to treat penicillins induced allergic reaction. The gallbladder channel and its corresponding Zang-organ liver are responsible for muscle and tendon level of body, the very same depth the vaccines are injected into. The liver belong to the Juéyīn-level and is responsible for detoxifying the body.

  1. In Sùwèn chapter 31 this order is Tàiyáng → Yángmíng → Shǎoyáng → Tàiyīn → Shǎoyīn → Juéyīn.
  2. http://gut.bmj.com/content/early/2010/10/21/gut.2010.219683.short
  3. http://www.telegraph.co.uk/health/healthnews/9171414/Swine-flu-vaccine-linked-to-sleeping-disorder.html

Emotional causes and Xīnbāo-theory of doctor José Luis Padilla Corral

心包絡經In clinical practice of Chinese medicine the patients are interviewed quite throughly. Practitioners quite often note how the diseases are triggered after prolonged emotional stress culminating in emotional turmoil . In clinical work this seems to be much more evident and common than the modern medical studies seem to indicate. It seems that it sometimes takes about 2-6 months after the worst peak in turmoil before the disease begins to manifest its first symptoms. The earlier beginning is however sometimes evident in patients dreams in few days. This delayed onset of symptoms can be one reason for statistic inaccuracies.
Some of the best treatment protocols for this kind of autoimmune disease have not been based on five elements but upon Xīnbāo-channel. Best Xīnbāo-channel based treatments that I have tried were developed by Dr. José Luis Padilla Corral. They are mostly based on idea of Xīnbāo and problems of identity and not being able to “follow ones own Heart”. Many times our minds, expectations, cultural conditioning and feelings “fight each other” creating “civil war” inside. According him this condition within body is one of the main reason for autoimmune response. His treatments utilized points from Xīnbāo and Gallbladder. His later treatment patterns used acupuncture and moxibustion to points like Bl22, Xb7, Du 10-11 plus selections very similar to those in Treating Autoimmune Disease With Chinese Medicine. In many cases both of the treatments based on Corral view have proven very fast and effective. The points in his later protocol however rise many thoughts in everyone familiar with Xiānghǔo lùn (Treatise on Ministerial fire).

Autoimmunity and Sānjiāo

Sānjiāo

Sānjiāo

Even though some of the autoimmune diseases are usually born with similar histories sometimes there seemed to be no relationship to previous symptoms or diseases. In these cases no amount of treatment with Five phases theory is enough to really extinguish the fire. The flames of inflammation always return sooner or later. If we wish to go deeper we need to take closer look to the root of the channels.
Sānjiāo is a peculiar channel or system. In relation to yuán points it is said in Nanjing 66:
“Under the navel and between the kidneys is moving qi. It is the life and fate of man. It is the root and source of 12 channels. That why they are called yuán (points). The Sānjiāo is the peculiar envoy of yuánqì. It is master of passages moving three qì. It channel passes in five Zàng and six fǔ. Yuán (origin) is the honorary title of Sānjiāo. Therefore [the points] where it stays seated are called yuán[-points].” (1)
The place between the kidneys and under the navel is the dantian or Mìngmén. Sānjiāo is the origin or source of all other meridians. Mìngmén is the ministerial fire. Zhū Dānxī (1280-1358) in his book Xiānghǔo lùn or Treatise on Ministerial wrote that “Only fire is twofold. [One] is called sovereign fire that is human fire; [The other] is called ministerial fire that is heavenly fire ”(2).
The ministerial fire as it is “born from Nothingness it holds [its] seat of behests. Because its movements are clearly visible we speak of ministerial [fire]”(3).
This is one of the ancient “secrets” now almost totally forgotten. For many the Sānjiāo is just a strange channel without much use save the local pain. The cosmology and the classics however explain the whole structure of human being stemming from Mìngmén through this ministerial fire. It is the fire of life in human being. The Xiānghǔo lùn further explains “[If] the Heaven were without this fire it could not give birth to beings. [If] Humans were without this fire they could not be born (or live).” (4)

So what does this fire mean for autoimmune disease? Zhū Dānxī explains how “fire stirs by expectations (wàng)”. This term wàng has lot of meanings. It means expectations, presumption, but also being false, double faced, pretentious, being full of oneself, absurd and disordered. This wàng is the reason for our stress. In modern world the most stress seems to come (according patients) from work, social relationships and also from within family. It can be that one is forced to act differently from ones feelings or own just have to repress the conflicting desires. Sometimes it is the hopeless dream one has had never courage to live. In many times these hope create false patterns of behavior, feeling and reacting as a way to cope with the tension inside.
This fire once aroused “transforms and changes without measures. It simmers and boils true Yīn. [When] Yīn is empty there is disease [after] yīn is exhausted there is death”(5). As the Sānjiāo is the source and root of all the channels the fire spreads to the other channels and starts acting as “the enemy of yuán qì” as it is expressed in Sùwèn. Zhū Dānxī quotes classics and commentaries and explains briefly how the different disease are born because of this fire.
This explains one one point technique that has proven the most effective in autoimmune treatments, the moxibustion of Sānjiāoshū (BL 22). You may wonder why to use moxa for fire but in this case it is using a human fire to sooth the heavenly fire as presented in Sùwèn. This usually cuts the process but you get lasting cure one needs to add points to release “expectations and pretenses” or wàngs according their nature.

  1. 《黃帝八十一難經 六十六難》 臍下腎間動氣者,人之生命也,十二經之根本也,故名曰原。三焦者,原氣之別使也,主通行三氣,經歷於五藏六府。原者,三焦之尊號也。故所止輒為原。
  2. 《朱丹溪相火論》 惟火有二,日君火,人火也。日相火,天火也。
  3. 《朱丹溪相火論》 生於虛無守位稟,因其動而可見,做謂之相。
  4. 《朱丹溪相火論》 天非此火不能生物,人非此火不能有生。
  5. 《朱丹溪相火論》 火起於妄,變化莫測,無時不有,煎熬真陰,陰虛則病,陰絕則死。

Hypothesis about Autoimmunity, Earth changes and the Sun

During past decades the autoimmune diseases have become more and more common. This might be due our own actions of poisoning our environment and food, increased use of vaccines and medications that are rarely properly prescribed. But still this does not explain all the cases. In modern times we also have much more freedom for self expression and less burdens from moral restrictions. How could the Sānjiāo and theory of ministerial fire explain the increase?
Zhū Dānxī referred ministerial fire as heavenly fire that is needed to give birth to the living things. This fire is the sun. Dàoshū (Daozang 1017 道樞) explains: “Man stands between Heaven and Earth in accordance of life. This is called Mìng (fate). [When] man is arriving as an embryo his kidney first receives it form. Then grows [others of the] five Zàng (organs). Therefore kidney is Mìngmén, The left [kidney] is Shǎoyáng that is like Heaven and Sun. The right is Tàiyīn, Earth and Moon. [Kidneys] are the Tàijí of the whole body, the ending sentence and the beginning of persons life.”(1)

Zhēnyī jīndān jué – Zhēnyī secrets of golden elixir (真一金丹訣) written by Wáng Chángjí (王常集) during Sòng-dynasty. It explains: “Channels are distributed up and down, left and right, throughout and everywhere. At the left there is a channel united with left kidney. It belongs to yīn, it is Moon and master of Water. Its number is one. At the right there is one channel united with right. Root of man before his birth in right kidney is Mìngmén. It belongs to yáng and is like Sun. Sun is master of three Hún and its color is red. It is fire. Fire suppresses Yuángōng (Palace of the Origin). Its number is seven.”(2)

In classical texts the human body is sometimes compared to Earth and it is being influenced by the sun, seasons and winds. The term Qì also means weather and air. Currently our sun has again shown increase in activity. The Earths magnetic fields has undergone changes and its magnetic poles have started moving with increasing speed. The earthquakes and volcanoes are experiencing up-ticking and the weather has given us a display of serious “anomalies”. It is being argued if this is man made phenomenon or if it is part of a normal cycle that modern man is yet unaware of. In either case the earth is undergoing changes in many levels and the whole nature humankind included has to adapt to these changes.

Graph showing solar activity events

The graph showing solar activity events. For more information please see http://en.wikipedia.org/wiki/Solar_variation

The Sun and Mìngmén in man are thought as fire of life. When this fire becomes highly active it burns through us like the spark of evolution and change. This fire acts in Shāoyáng level and can easily make some aspects like immune system overactive, especially if there is no balance within and there is lot of those “expectations and pretenses” (wàng). If it can pass through unobstructed it changes and transforms us and helps us to adapt. Zhū Dānxī quoted Zhōuzǐ (周子) and Zhūzǐ (朱子) and told how “the sages were fixed in their centers, were truthful, humane and righteous and mastered stillness”(3). If one “acts as Tao was his Heart and master of body then his human heart always hears(4) his destiny. This is truly the proper way to deal with the fire!”(5)

  1. 《道樞》人受天地之中以生,所謂命也。人之就胎,其腎先受形焉,次之以生五臟,故腎為命門者也。其左為少陽,為天,為日;其右為太陰,為地,為月,是一身之太極判而始生者也。
  2. 《真一金丹訣》 經分上下,左右衝通,左有一經,連左腎,屬陰為月,主水,數之一也;右有一經連於右腎,本男先生於右腎,為命門,屬陽為日,日、王三魂,色赤為火,火鎮元宮,數之七也。
  3. 《朱丹溪相火論》 圣人定之以中正仁義而主靜。
  4. Tīng (听) means to listen, hear and obey.
  5. 《朱丹溪相火論》比使道心常為一身之主,而人心每听命焉。 此善處乎火者。

Sources

张仲景:傷寒論
朱丹溪:相火論
黃帝八十一難經
黃帝內經素問
黃帝內經靈樞
Treating Autoimmune Disease With Chinese Medicine written by Wanzhu Hou, Guangpi Xu and Hanjie Wang (ISBN 978-0-443-06974-1)
Notes from Autoimmune Diseases lectures held by Gandul Saris-Sauri, Neijing-school May 20-21 2006.

Additional sources for those interested in connection between Sun, ionosphere, magnetosphere and earthquakes:

Induction magnetometer, http://www.haarp.alaska.edu/cgi-bin/scmag/disp-scmag.cgi
Digisonde Scaled Data, http://www.haarp.alaska.edu/cgi-bin/digisonde/scaled.cgi
HAARP VHF Riometer, http://www.haarp.alaska.edu/cgi-bin/riometer/riom2_sel.cgi
Ionospheric Map, http://www.ips.gov.au/HF_Systems/6/5
Integrated space weather analysis system, http://iswa.gsfc.nasa.gov/iswa/iSWA.html
Solar dynamics, http://sdo.gsfc.nasa.gov/data/
Space weather, http://spaceweather.com/
Seismic monitor, http://www.iris.edu/seismon/
University of Delaware: Bartol Research Institute – Neutron monitor program,
http://neutronm.bartol.udel.edu/
GNSS and Ionospheric Scintillation, http://www.insidegnss.com/node/1579
SWMF (Magnetosphere-Ionosphere) Real-time run, http://ccmc.gsfc.nasa.gov/cgi-bin/SWMF_RealTime_browse.cgi
Plot of solar cycle 23 and 24 sunspot data, http://www.nwra.com/spawx/ssne-cycle2324.html

A statistical study on the effect of earthquakes on the ionosphere, based on the subionospheric LF propagation data in Japan, http://hal.archives-ouvertes.fr/hal-00318154/

Physical mechanism of the action of solar activity and other geophysical factors on the state of the lower atmosphere, meteorological parameters, and climate, http://iopscience.iop.org/1063-7869/36/7/A09/pdf/1063-7869_36_7_A09.pdf (not free!!!)

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Great news from the International Taoism Forum

The International Taoism Forum

Respecting the Tao and Honoring the Virtue for Harmonious Co-existence

temple

I had the great honor of being invited to China for the International Taoism Forum held during 22-25.10.2011. The forum was organized by Hunan Organizing Committee of International Taoist Forum and sponsored by Chinese Taoist Association, China Religious Culture Communication Association, Hong Kong Taoist Association, Macao Taoist Association and Chinese Taoist Society (Taipei, Taiwan)

zhurong-peakThe forum took place in China, Hunnan province, at Nanyue Hengshan mountain (南岳衡山). The mountain area was extremely beautiful. About 300 invited guests were present. The guests were Taoist leaders, internationally recognized experts and scholars, and personalities from political, economic and cultural circles. Most of the invited people were coming from China, Hong Kong, Macau and Singapore. About 20 people were form Europe. There were also people from Australia, USA, Canada and Mexico. The media was also following the forum with many newspaper reporters and TV recordings.

cohere-lobbyThe forum itself had been organized with utmost care and consideration. There were guides and transportation between sites. The language barriers were overcome with simultaneous translations to English (and to Chinese when the speakers were not native Chinese speakers). The accommodation was in very high class hotels like five-star Changde Cohere Hotel. At the hotel there were choice between Western and Chinese food. I chose to eat Chinese food. The food was exquisite. (I miss it already). And as a foreign guest I had the luxury of having very friendly and talented personal guide arranged to help and escort me around. She informed me about everything I wished to know and organized the transportation to seminars I wished to attend.

Topics of the Forum

The topics of the forums were:

  • The Nature of the Tao and Sustainable Development
  • Valuing and Enjoying Life, and Attaining Happiness
  • Benevolent to Everyone and Cooperation for Win-win progress
  • Returning to the Essence, Cherishing Truth and Protecting Spiritual Wellbeing

 

forumThe focus of discussions and presentations were mostly about Taoism and its meaning for modern world and how the ancient Taoist ideas, values and practices might benefit the modern society and ease the crisis that the whole world is currently facing. The future of the planet looks disastrous if something is not done. The forum was intended to promote Taoism and to introduce ideas for the change needed.

In the presentations the Taoist ideals of simplicity of life and quieting the over fast pace of living was seen as balancing factor for consumerism and industry. The caring of nature and the fundamental Taoist conception that the humans being are part of the nature is more and more important in modern life. Without these ideals the ever growing industrial development, expanding cities and ever growing capitalism with lack of morals will soon use up and destroy the natural resources and balance. As the people will have hard time finding balance between the desire for more luxurious life style and simplicity needed to conserve new ways of more fulfilling and satisfying lifestyle must be found. The advancements in science and ecological fields was seen as one way of creating both success and preserving the nature.
The ideal of tolerance was clearly apparent in speeches. The dialogue between East and West and between different religions was greatly encouraged. The utilization of new scientific discoveries were cherished. Instead of blaming or judging there was hope for new ways of co-operation and returning to ancient values of honoring the nature.

The essence of Taoism is harmony, purity and simplicity. The harmony between the humans and the nature is essential for well-being for humans and nature. The harmony in society is essential for success of its members and the harmony within an individual can bring spiritual and physical well-being.

Chinese/Taoist Medicine and Acupuncture

The forum also held great promise for everyone interested in Chinese Medicine or should I say in this content Taoist medicine. There were many people having great concern about the loss of roots in constant modernization of Chinese medicine. The attendees, as one can guess, were well aware of broadness of the ancient philosophy and knew the Taoist basis of Chinese medicine. During the forum I spoke with many people interested in making these ancient roots more available and known. Many researcher, Taoist priests and Chinese medicine professionals were interested in translating and making public the ancient Taoist classics containing ancient medical knowledge. Many wanted include ancient classics to teaching of Chinese medicine. The promotion of ancient classics, Taoist, Buddhist and medical writings was seen as the way to help the people truly to understand the Chinese medicine. It will contribute overall quality of practice of Chinese medicine everywhere.

If we together can initiate the changes that were brought up in the discussions the Chinese medicine will in the future see more translations, publication of classics in many languages and better availability of medical classics that western people have not seen before. Many classics and other writings are currently only available in the temples but they can be made available also in electronic forms. This is great news for every researchers, translators and general public interested in Taoism and medicine.

Acupuncture and Diaphragm

Short notes on Acupuncture and Diaphragm

Diaphragm

The ancient character for 鬲

The ancient character for 鬲

The diaphragm and its constriction caught my attention some years ago as I noticed that most of the patients coming to the “infertility” treatments had their diaphragm constricted, coldness of abdomen, cold womb and many of them had acid reflux.

Physically the diaphragm is a sheet of muscle separating thoracic cavity and abdominal cavity. The diaphragm plays important role in respiration, and is also involved in vomiting, expelling feces and urine. The pressure from diaphragm helps esophageal hiatus to preventing acid reflux. The muscular structure is also connected to ligaments of vertebral column.  The diaphragm is innervated by phrenic nerve formed from nerves coming from C3-C5.

In Chinese medicine

In classic medical texts the problems of diaphragm are usually seen more as symptoms of disease than the source of the problem. Most of the classics speaks of heated, cold, full or distended diaphragm. The symptoms mentioned in connection are mostly of vomiting, constipation/diarrhea, food retention, qì rebellion and breathing difficulties.

However the problem is much deeper. For example physician named Yùchāng (喻昌) wrote in 1645 in Yùyìcǎo (寓意草) how the dàlùo of Stomach and the qì of Lung go through the diaphragm. Because of moving and transformations of jīng, blood and qì the constricted diaphragm is seen to cause serious problems as it is “Not only the womens disease but also the child [in womb and while breatfeeding] loses it nourishment”.

When we look at the channel pathways we can see something very interesting:

  1. The Stomach channel coming downwards from the throat goes downwards and goes through the diaphragm area. The dàlùo of stomach goes from stomach to lungs passing the through the diaphragm as it goes.
  2. The Spleen channel likewise go through the diaphragm as it ascends. One branch that enters the spleen and stomach rise from stomach through the diaphragm and enters the Heart.
  3. The Lung channel beginning from the middle burner descends to the lower burner and ascends again passing the diaphragm before entering the lungs.
  4. The Large intestine channel after ascending the arm goes from Li15 to Du14 and goes to qūepén area where it branches. The descending branch enters the lungs and penetrates the diaphragm before entering the colon.
  5. The Heart Channel starts from the Heart and descends through the diaphragm to small intestine. The Heart also has network of connection to every Zàng-organs and most of these connections has to go through the diaphragm.
  6. The Small intestine channel after rising the arm branches at the qūepén area. The descending branch goes to Heart and descends further through the diaphragm to small intestine.
  7. The Kidney channel goes through diaphragm area while ascending before it dives to the Lungs and Heart.
  8. The liver channel after ascending from toes to abdomen enters the liver and gallbladder and continues to ascend through the diaphragm to costal region and finally to throat.
  9. The Gallbladder channel descends from qūepén area down the chest passing the diaphragm and enters the gallbladder and liver.
  10. The Sānjiāo channel branches after reaching qūepén area and the one part of it goes down to chest connecting Xīnbāo and descending trough the diaphragm to connect all the three burners.
  11. The Xīnbāolùo Channel starts from the chest and descends through the diaphragm to join the three burners.
  12. The Rènmài  pass through the diaphragm and the rènmài 15 is seen as a lùo-point of Rèn as from there the channel branches and the branch disperses to diaphragm.
  13. Chòngmài as it rises from womb it passes through the diaphragm. Chòngmài is responsible of red blood transforming to white milk during the breastfeeding.

There are also numerous other connections from different branches of the main channels. And as the diaphragm is a muscle it is very important to note that the Stomach, Spleen, Heart and Xīnbāo muscle channels all connect to the diaphragm.

From this it becomes clearly understandable why the diaphragm plays such important role upon all the ascending and descending within the energy system.

In alchemy

The diaphragm in Chinese language is 膈 (gě). Today the character for diaphragm is written with flesh radical (月 + 鬲) and the whole character is translated as diaphragm. The older form of character omits the flesh radical and the simple 鬲 translates as iron cauldron or earthen pot. This older name reveals much clearly the function of the whole diaphragm.

All the six fǔ-organs and three of the five zàng-organs reside below the diaphragm. Only the Heart and Lungs reside above it. The diaphragm stands between the upper and lower, separating them. The qì and jīng are below and the source of blood (Heart) is above. Water (Kǎn) below and Fire (Lí) above. In cultivation practices the diaphragm is very important as it controls the rising and descending of fire and water. It mixes the yuan qì and post heaven qì. The earthen pot is the whole abdominal area where the cooking of alchemical herbs is done.

In inner alchemy the diaphragm is connected to following “parts of the body”:

  1. Squeeze the spine pass (夾脊關 – Jiājǐguān) in the back
  2. Doves tail (鳩尾 – Jiūwěi) and Crimson palace (Jiànggōng) in the front
  3. The Great gate tower (巨闕 – Jùquè) within.

In emotional level the diaphragm works as an emotional shield and bridge between the unconscious and conscious emotions. It can block the emotions stored in the lower abdomen from over-flooding the Heart and consciousness. Its functioning can be easily observed in children. When the emotions are too hard to deal with the diaphragm becomes tense and whole upper stomach get tense. The sobbing, crying or vomiting are biological ways of relieving the formed tensions. Quite common result of diaphragmatic tension is digestion problems or diminished appetite. One very common manifestation of this blockage is that there is cold and possibly qì masses or even blood stagnation masses below while there are heat and fullness above manifesting as symptoms like feeling of stuffiness at the chest and throat, nausea and acid reflux.

It also seems that many common anti depression medicines block the diaphragm. This also might explain some of the most common side effects like nausea and heart-burn. Sometimes you can see how medicated bodies express strange division where rest of the body still show the emotional strain while the facial expressions seem tranquil and rationally distant. In these cases the certain caution is in place while treating the area.

Acupuncture and diaphragm

One commonly used acupuncture point is called 膈俞 (Bl 17 – gěshū).  In Nánjīng reads “血會鬲俞”, meaning that the Blood meets or collects in Gěshū. The point is seen as “master of blood” as the Heart above produces the blood and the liver below stores it. This point is commonly used in many Blood related diseases and it is great for moving blood and qì. Shū point are places from where channel branches to fill places/organs with qì. The great meaning of point is revealed while applying moxa here as it results in warming the whole abdomen or the cauldron for alchemical cookings.

The point lateral to Gěshū is much less used point called 膈關 (Bl 46 – Gěguān). It is a great point to open the diaphragm and open the lid upon the cauldron. This point is better for opening the diaphragm than the Gěshū.

In front we have Ren 14 Jùquè (巨闕). The name means the great gate tower. It is the mù (募) point of the Heart. It is the watchtower to protect the imperial city. At the back there is also hidden points called 巨闕俞, the shū point for this watchtower.

In emotional problems with constricted cauldron one of my favorite ways of opening the diaphragm is to first needle Gěshū and Gěguān in intention of first stirring the cauldron and opening the lid. Then using qìgōng at Jùquè to very genty open the gates to the Crimson palace of Heart.

One good point for very prolonged blockage is Ren 15 – Jiūwěi (鳩尾). Jiūwěi means Doves tail. It is also called  Shéns treasury (Shénfǔ 神府). The point is yuán point for gāo (膏) and the point has a great effect to all the Zàng-organs. This point is also the lùo-point of Rènmài. The lùo merges to the diaphragm. It is said that when one descends from here he/she becomes tangled in emotions and thoughts of later heaven and when one ascends from here one returns to the Palace of Shén.

These are just a few points affecting the diaphragm. Other common points include other local points (mostly stomach and kidney channel points). Also because the fact that diaphragm is a muscle and the courses of muscle channel pathways the distal points of Spleen, Stomach, Heart and Xīnbāo channels are also effective.

It is very important to be very gentle while trying to open the diaphragm. Any tension or forcing will easily prevent the opening from happening. The opening is sometimes accompanied with involuntary laughter, crying, sobbing and/or shaking. Care must be taken that the emotions have time to settle down before leaving the patient.