20 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory Journal of Chinese Medicine • Number 102 • June 2013

Introduction to Neijing
Classical Acupuncture
Part II: Clinical Theory
Abstract
By: Edward Neal As outlined in Part I of this article, the theories and practices of Neijing classical acupuncture are radically
different from the type of acupuncture commonly practised today. In essence, Neijing classical acupuncture is
Keywords: a form of clinical surgery, the goal of which is to restore the body’s circulatory pathways and tissue planes to a
Acupuncture, state of dynamic balance. In its clinical application, Neijing classical acupuncture is a physician-level skill built
Neijing, classical, upon a sophisticated understanding of the innate patterns of nature and an in-depth knowledge of the structure
history, basic and physiology of the human body. Neijing classical acupuncture does not depend on point-action theory - the
principles conceptual framework that dominates most current thinking in modern acupuncture - for its therapeutic efficacy.
Rather, the goal of Neijing classical acupuncture is to regulate the different tissue planes of the body in order to
restore the free circulation of blood, and in doing so allow the body to return to its original state of balance and
innate self-healing.

I. Background theoretical descriptions of acupuncture were outlined

The detailed writings laid down in the original texts in the original medical texts where their core principles
of Chinese medicine during the later Warring States
period (475-221 BCE) and Western Han Dynasty (206 that is the least understood today.3
BCE-9 CE) represent a comprehensive theoretical
system that has stood the test of time for over two History of the Lingshu family of texts
millennia. To date, no other system has come close
to displacing these foundational ideas from their therapy were set down in the Huangdi Neijing Suwen
preeminent position. Despite this, in part due to the & Lingshu (Yellow Emperor’s Inner Classic Plain Questions
literary purges of the Qin Dynasty (221-206 BCE), as & Divine Pivot).4,5 Of these, the Huangdi Neijing Lingshu
early as the Western Han Dynasty (206B CE-9 CE) emphasises the principles of acupuncture practice and
theory.6 The title ‘Lingshu’ is one of several names used
previous periods.1 Early medical commentaries such to describe a collection of writings on acupuncture
as the already display that were either similar or identical in content. Other
fundamental misunderstandings of basic Neijing (Inner common names used to describe these texts include
Classic) medical theory.2 Historical commentaries the Zhenjing (Needling Classic), Jiujuan (Nine Rolls) and
written over subsequent dynasties commonly display Jiu Ling Jing (Nine Divine Classic), amongst others. 7,8,9

and political contexts of the times in which they preface to Zhang Zhongjing's Shanghan Zabing Lun
were written. Further, medical training in China has (Treatise on Cold Damage and Miscellaneous Diseases,
historically been handed down through a combination Eastern Han Dynasty 220 CE), in which the author

training systems that display a wide variety of skill, Later, during the Three Kingdoms period (220-280
clinical understanding and system biases. Taken as
a composite whole, the development of acupuncture portions of his seminal treatise, the Zhenjiu Jiayi Jing
practice is not easily summed up by a simple narrative. (The Systematic Classic on Acupuncture and Moxibustion)
Thus, whilst it is perhaps easy to imagine the evolution from passages taken directly from the Zhenjing
of acupuncture as being something that has progressed (Needling Classic).11
smoothly from the primitive to the sophisticated, the
truth is somewhat more complex. Critically, while term Lingshu is found in Wang Bing’s revision of the
advancements have been made in both practice and Neijing, which was completed in the Tang Dynasty in
experience, the most comprehensive clinical and 762 CE. Later, during widespread editing of medical
Journal of Chinese Medicine • Number 102 • June 2013 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory 21

manuscripts that occurred in the Northern Song (960- that of being a cultural treasure that was emblematic of
1127 CE), the Lingshu text was found to be incomplete. traditional culture and values.18 Importantly, all of these
Because of this, the Song court requested the return of a
copy previously loaned to the Goryeo Emperor in Korea
in 1091 CE. In 1093 the Song Emperor decreed that the (a practice that continues to this day). In the end, these
Lingshu views led to the construction of the widely disseminated
of all physicians.12 The earliest extant version of the Lingshu medical practice that is known today as ‘TCM’ (traditional
was published by the Gulin Shutang ( ) publishing Chinese medicine).19
house in the Yuan Dynasty (1271-1368 CE) and is housed in Although generally structured on Chinese medical
the National Library in Beijing.
During the neo-classical revival of the Northern Song medicine, in most cases the medicine the world now knows
as TCM bears little resemblance to the style of medicine
effort to counter a perceived deterioration in medical care practised by classically trained physicians of earlier
and return medical practice to its classical roots. During this generations. TCM itself evolved as a hybrid expression of
time the imperial court physician Wang Weiyi (987-1067 various training programmes aimed at educating Chinese
CE) constructed two well-known life-sized bronze statues, students of Western medicine and practising biomedical
complete with internal organs and acupuncture points.13 physicians in the basic principles of Chinese medicine.20
It was also during this period that imperial medical At the request of the Chinese government, senior Chinese
physicians prepared course materials - abbreviated by
were instituted. Thus while medical scholarship during the necessity in both theoretical content and complexity - to be
Song dynasty succeeded in resurrecting and augmenting used to explain fundamental concepts of Chinese medicine
concepts of classical scholarship, it also contributed to an to those not versed in its practice. These courses presented
orthodoxy of medical practice that persists to the current
day.14,15,16 side-stepping the complex medical theories that had served
During the Ming Dynasty (1368-1644 CE), the system as the foundation of Chinese medical practice for over 2000
of point-based acupuncture theory was elaborated in
Zhen Jiu Jie Yao training programmes that initially made its way to the West
(Acupuncture and Moxibustion Topics and Essentials) by Gao through the writings of different Western authors. These
Wu, the Zhen Jiu Wen Dui (Acupuncture and Moxibustion
Questions and Answers) by Wang Ji and the Zhen Jiu Da to the concept of a ‘traditional Chinese medicine’.21 While
Cheng (Great Compendium of Acupuncture and Moxibustion) Western readers believed that they were being given a
by Yang Jizhou. glimpse into the practices of an ancient culture, they were
By the latter half of the Qing Dynasty (1644-1911 CE) the in fact being introduced to an educational curriculum
developed to teach Chinese medicine to Chinese physicians
in both stature and quality. By 1822 the government ordered trained in Western medicine during the 1950’s and 60’s. In
that the departments of acupuncture and moxibustion be a bizarre pedagogical twist, the theories and practice of
closed within the imperial clinics, although its practice TCM achieved such status and popularity in the West that
17
they were eventually reimported back into China, largely
displacing the study of the classics and traditional medical
The development of TCM theory in the early 1980’s.22
Following the succession of the PRC (People’s Republic
of China) in 1949, the Communist government took a II. Clinical principles of Neijing classical
variety of positions with regard to traditional Chinese acupuncture
In contemporary practice, acupuncture therapy is currently
by conventions of the late imperial period - continued to understood to be an adjunctive therapy indicated for the
be practised, the government agenda was dominated by treatment of a variety of common - but non-life threatening
several sociopolitical concerns, including a perceived need - diseases such as general pain disorders, paralysis,
insomnia, psychological disorders, migraine headaches,
pressing public healthcare demands, limited healthcare digestive disorders and stress.23,24 However, it is important

it was seen to be the primary medical intervention for

and political and cultural pressures to retain traditional the treatment of patients with critical and life-threatening
illnesses.25 Most clinical descriptions found within the
of the government varied from describing traditional Neijing describe medical conditions that today would be
medicine as something outdated and superstitious to found in modern hospital in-patient wards, emergency
22 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory Journal of Chinese Medicine • Number 102 • June 2013

rooms, intensive care units and hospice settings.26 Further, Similar to the Mawangdui medical manuscripts, in the
at the time these texts were written, no tertiary medical Neijing the preeminent circulatory pathways of the human
backup existed. Frequently, all that stood between a body are described as being ‘mai’ vessels (see Figure 1).28 In
patient’s death or survival were the skills and experience of Chinese, the character ‘mai’ ( ) is a basic anatomical term
the acupuncture physician. That these practices persisted
portions of the original mai vessel pathways can still be
mass casualties of war and periods of great morbidity and traced within the modern acupuncture channel system,
mortality suggests that at the very least they are worthy of
closer scrutiny and research.27 original course descriptions. The acupuncture channel
The basic principles of the clinical practice of Neijing systems now widely taught and used in clinical practice all
classical acupuncture may be summarised as follows: have their origin in the descriptions of mai vessel pathways
found in Chapter 10 (Jingmai , Channels and Vessels)
Principle #1 of the Lingshu. Within these passages the terminology of the
mai vessel is clearly evident; taking the Lung pathway as
an example:

‘ ’ (Literally, ‘Lung; hand; taiyin’s;

‘The Lung hand taiyin ( greater yin) mai vessel originates mai vessel; arises; in/from; middle; jiao.’; or stated more
from zhongjiao ( middle burner). Descending, it nets clearly, ‘The mai vessel of the Lung hand taiyin arises from
with the Large Intestine and then returns to pass weikou ( the middle burner.’)29,30
stomach mouth). It then ascends through the diaphragm
and joins with the Lungs.’ In modern times, any references to mai vessels and the rich
- Lingshu Chapter 10
impart are generally omitted from English translations
of Chinese source texts, and they are rarely recognised as
being a part of Chinese medicine theory.

In this illustration, the Lung mai vessel

is shown where it exits the axilla in the region of the axillary artery. In the
Neijing this region was called ‘Tianfu’ ( heavenly palace). Tianfu is
now the name of the modern acupuncture point LU-3. [image from http://
en.wikipedia.org/wiki/File:Gray523.png]

Figure 1: In the Neijing the primary circulatory pathways of

the body were described in terms of mai (blood) vessels. Later, the mai
vessel system evolved to become the twelve primary channels. [image
courtesy of Getty Images].
Journal of Chinese Medicine • Number 102 • June 2013 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory 23

Classical Chinese blood circulation Biomedical blood circulation

Blood is circulated by the Lungs. Blood is circulated by the heart.
Blood flows through a continuous loop of mai vessel pathways, Blood cycles back and forth between the arteries, capillary beds,
passing back and forth between the exterior and interior of the veins, lungs and heart.
body.
Blood forms from the products of digestion and respiration. Blood results from haematopoietic stem cells derived from bone
marrow.
Blood vessels are called ‘mai’ ( ) vessels. Blood vessels are differentiated into arteries, veins and capillaries.
Mai vessels communicate freely with local tissue planes, similar to Arteries and veins are viewed as closed systems that communicate
the communication that occurs between a river and its riverbank. with the body’s tissue planes via terminal capillary beds.
Blood flows either from earth to heaven (a mu wood circulation) Blood flow is differentiated into arterial and venous circulation.
or from heaven to earth (a jin metal circulation).

Principle #2 Principle #3

‘ .’ ( ).
‘The mai vessels are the fu (
- Suwen Chapter 17 ‘
‘ .’ .’
‘The Heart joins with the mai vessels.’ ‘It is through the twelve jingmai ( channels and vessels)
- Suwen Chapter 10 that human beings are born and [are able to live their] lives.
Within them illnesses arise, illnesses are cured and illnesses
As stated above, the character ‘mai’ ) is a relatively worsen. When beginning their study of jingluo, the lower-
straightforward anatomical term that means ‘blood vessel’. 31,32,33 level physician believes this knowledge is something
Therefore, the mai vessel pathways described in the Neijing easily acquired. It is the superior physician [alone] who
represent a comprehensive and straightforward description
of the early Chinese conception of human blood circulation - Lingshu Chapter 11
(see Figure 2).34,35,36 In these descriptions, blood has its
origin in the products of digestion in the middle burner. In modern TCM the term ‘jingluo’ ( ) is commonly
translated as ‘channels and collaterals’. It is a term typically
the Liver and Heart via collateral circulations. A majority used to describe the basic pathways of the acupuncture
of this ‘proto-blood’ then circulates to the Lungs where channel network and its associated structures. However,
it is vitalised by the qi of the atmosphere to become fully as is often true of the key terms in Chinese medical
terminology, the term jingluo contains both primary and
secondary meanings.39
by a variety of anatomical, theoretical and physiological jingluo describes generic patterns of nature’s growth
concerns.37,38 Several key factors serve to differentiate cycles. Only secondarily do these terms describe discrete
classical and modern conceptions of blood circulation (see anatomical structures of the human body.
Table 1). For the authors of the Neijing the free circulation
of blood within the mai vessel pathways was the end
goal of each acupuncture treatment; it was not (with few
exceptions) the activation of individual acupuncture points
24 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory Journal of Chinese Medicine • Number 102 • June 2013

patterns found in nature as well as to structural patterns

that traverse the fascial body running centrifugally from the
interior/centre to the exterior/surface, are diffuse in nature
and do not cross the major joints of the body.43 In terms
of classical anatomy, these basic patterns exist whether
one is speaking of the different divisions of fascial plane
anatomy or the circulation of blood (mai) vessels. When the
authors of the Neijing desired to focus their discourse on the
circulation of blood, they simply added the qualifying term
‘mai’ to the basic descriptors of longitudinal and horizontal
patterning to form the composite terms ‘jingmai’ ( ) and
‘luomai’ ( ).

In Neijing terminology, generic yang patterns

of development are called ‘jing’ ( longitudinal patterning). Yang patterns
of growth develop in longitudinal or vertical patterns, have a supportive

same character jing ( ) is used to describe longitudinal divisions within

the body’s fascial planes. These connective tissue pathways are now called
‘acupuncture channels’ (although many modern channel pathways have

en.wikipedia.org/wiki/File:Redwood_National_Park,_fog_in_the_forest.jpg]

According to basic Neijing medical theory all living things

are seen as being primary expressions of the universal
yinyang breath.40 As living things grow and mature they are
seen to evolve along both yin and yang lines of patterning.
In a generic sense, yang patterns of development are called
‘jing’ longitudinal patterns). Yang patterns are concrete,

In Neijing terminology, generic yin patterns of

vertical manner (see Figure 3). Yin patterns of development development are called ‘luo’ ( horizontal network patterning). In contrast
are generically called ‘luo’ ( horizontal network patterns). to yang patterns, yin patterns develop as a series of horizontal networks that

In contrast to yang patterns, yin patterns are more diffuse, jingluo theory, the same character ‘luo’ ) is used to describe the divisions
harder to identify as discrete structures and develop as of the body’s connective tissue planes that move from the centre to the surface
of the extremities and do not cross the major joints of the body. [image from
networks of horizontal branching structures (see Figure https://en.wikipedia.org/wiki/File:Hedera_canariensis_ Gomera.jpg]
4).41 Out of this basic dichotomy of generic developmental
growth patterns arises a comprehensive and theoretically
coherent construction and understanding of human Since shared generic patterns were seen to exist in both
anatomy. the human body and the natural world, direct correlations
In Neijing medical theory – as in the vast majority of
classical Chinese philosophical thought – ontological
patterning (li ) is seen to be primary and manifestations way, within the body’s anatomy, mai vessel circulation
of that patterning (xing ) are seen to be secondary. In
the same way, ancient Chinese physicians/scientists
understood generic patterns of nature to be primary, and longitudinally they are referred to as ‘jing’ patterns. When
discrete anatomical descriptions of the human body to be
secondary. Thus, while a complex variety of anatomical ‘luo’ patterns. This style of correlative thinking is evident in
terms are used within the Neijing, they are all seen to Lingshu Chapter 12 (Jingshui Channel Waters), where
develop from a few basic patterns of nature. a direct correlation is made between the patterns of the
In the anatomical terminology of the Neijing, the character twelve primary mai vessels of the body and twelve of the
‘jing’ ( ) refers both to generic developmental patterns that primary bodies of water of ancient China (see Table 2 and
occur in nature and also to structural patterns of the fascial Figure 5).44 Here, the patterns of the greater macrocosm and
body that longitudinally traverse the bodies structures the inner anatomical landscape are both understood to be
passing through the major joints of the body.42 Likewise, formed upon a shared template.
the term ‘luo’ ( ) refers both to generic horizontal network
Journal of Chinese Medicine • Number 102 • June 2013 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory 25

Primary mai vessel Lingshu water Within the body, the six primary longitudinal mai vessel
correspondence
the body’s tissue-plane anatomy. In nature, a watershed is
Lung Huang He (Yellow River )
Large Intestine Jiang He (Yangtze River )
Stomach Ocean and Seas ( )
Spleen Lakes and Marshes ( ) fauna, different variations in soil and mineral composition
Heart Ji river ( ) and a complex system of tributaries and central
Small Intestine Huai river ( ) watercourses. In a similar way each of the six anatomical
Bladder Qing river ( ) zones described in the Neijing contain distinct regional
Kidney Ru river ( ) tissue-plane features such as tendons, blood vessels, bones,
Xinzhu (Heart Ruler) Zhang river ( ) skin and fat (see Figure 6).
Sanjiao Ta river ( )
Gall Bladder Wei river ( )
Liver Mian river ( )

Lingshu In Lingshu Chapter 12 each

primary mai vessel is matched to one of the bodies of water in ancient China.

of others been lost or altered.

Because all of the anatomical structures of the human body

are seen to form from different combinations of yinyang
growth patterns, the term ‘jingluo’ ( ) is a comprehensive
term that describes the entire three-dimensional anatomy of
the human body. Neijing jingluo theory greatly exceeds the

anatomical accuracy and clinical relevance.45 Importantly,

because classical jingluo theory offers a description of
Historically, the
the human body that is grounded in anatomical reality, it Yellow River has been described as the geographic heart of China. Known as
provides a bridge to Western biomedicine that has been
the Tibetan plateau to enrich the agricultural regions of the Yellow River
lacking in modern descriptions of Chinese medicine. basin. In the Lingshu the Yellow River is correlated with the Lung mai vessel.
In both cases, these pathways carry nutrient rich material into their respective
circulations. [image from https://en.wikipedia.org/wiki/ File:Hukou_
Principle #4 Waterfall.jpg]

The ancient Chinese physician/scientists carefully

observed the manifestations of nature and the effects that
‘ the waxing and waning cycles of yin and yang had on the
human body. They saw that as the physical universe moves
.’ through different states of cyclical change, the body mirrors
‘In regards to the separation and reunion of the three yang: and tracks these changes with reciprocal motions of its
taiyang opens ( ), yangming closes ( ) and shaoyang own. Similar to the movements of plants and vegetation,
pivots ( ). These three jing ( ) should not contend and the human body was seen to open and close in relation
defeat one another. When this happens [yang] cannot to basic cycles of yinyang expansion and contraction. In
circulate within the exterior. [Together] they are called “one addition, a fundamental tenet of yinyang theory is that
yang” … In regards to the separation and reunion of the nature’s circulations are tidal in quality, moving back and
three yin: taiyin opens ( ), jueyin closes ( ) and shaoyin forth between two positions of polar opposition (see Figure
pivots ( ). These three jing ( ) should not contend and 7). In this process, three primary axes of variable motion
defeat one another. When this happens [yin] cannot sink
deeply within the interior. [Together] they are called “one called ‘kai’ ( opening), ‘he’ ( closing) and ‘shu’
yin”. Yin and yang move in an unending pattern, moving pivoting).
and transforming in a circle without end.’
- Suwen Chapter 6
26 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory Journal of Chinese Medicine • Number 102 • June 2013

Within the Neijing, each mai vessel course

traverses distinct tissue planes containing fat, fascia, sinews, collateral blood that opens, closes and rotates in response to the daily cycles of the sun, the
vessels, skin and bone etc. Each of the different layers of the body’s tissue human body also moves through the primary motions of ‘opening’, ‘closing’
planes are formed on a shared pattern template, although their manifestation and ‘pivoting’. [image from http://en.wikipedia.org/wiki/File:Iglesia_de_
varies depending on the type of body tissue being expressed. [image from Nuestra_Señora_de_La_ Blanca,_Cardejón,_España,_2012-09-01,_DD_02.
http://en.wikipedia.org/wiki/ Magnetic_resonance_imaging] JPG]

Three primary degrees of change moving in two polar Principle #5

opposite directions yields a total of six primary qualities
of motion within nature and the human body. In Neijing
medical theory, each of the body’s anatomical watershed
zones has governance over one of these primary axes of
change. In the Neijing, the names of the anatomical regions
which govern these movements are called shaoyang ( ‘
lesser yang), yangming ( yang illumination), taiyang ( .’
greater yang), jueyin ( reverting yin), shaoyin ( ‘Man has three hundred and sixty physical demarcations
lesser yin) and taiyin ( greater yin). Many clinicians (jie ). These correspond to the numerical patterns of
and students are familiar with these basic terms, although
their original meanings are not widely appreciated or the material substance of earth. Above there are ears, eyes
understood (see Table 3). and mental intelligence. These correspond to the sun and
the moon. The body has surface depressions, openings,
terrain patterns and mai vessels. These resemble the river
valleys (chuan gu [of the earth].’
- Chunqiu Fanlu Roll Thirteen (Spring and
Autumn Exuberant Dew Annals, Western Han Dynasty)

Watershed Action Directional root Mai vessel watershed

Taiyin ( ) Opens the interior Spleen (lower) Lung (upper) Spleen mai vessel (lower) Lung
mai vessel (upper)
Jueyin ( ) Closes the interior Liver (lower) Xinzhu (upper) Liver mai vessel (lower) Xinzhu
mai vessel (upper)
Shaoyin ( ) Pivots the interior Kidney (lower) Heart (upper) Kidney mai vessel (lower)
Heart mai vessel (upper)
Taiyang ( ) Opens the exterior Bladder (lower) Small Intestine Bladder mai vessel (lower)
(upper) Small Intestine mai vessel
(upper)
Yangming ( ) Closes the exterior Stomach (lower) Large Stomach mai vessel (lower)
Intestine (upper) Large Intestine mai vessel
(upper)
Shaoyang ( ) Pivots the exterior Gall Bladder (lower) Sanjiao Gall Bladder mai vessel (lower)
(upper) Sanjiao mai vessel (upper)
In the Neijing
Journal of Chinese Medicine • Number 102 • June 2013 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory 27

Chinese name Original meaning Modern point

Quepen Region between the clavicle and scapula ST-12
Tianfu Pulsation of the axillary artery LU-3
Qijie Region where major vessels pass through the groin ST-30 (now called Qichong)
Futu Front of the quadriceps muscle ST-32
Wangu Mastoid process GB-12
Renying Carotid artery ST-9
Neijing In many cases, modern acupuncture point names that are taken from Neijing descriptions were originally understood to be
broader anatomical and functional areas of the body.

In the majority of cases, anatomical terms now used to example of xue-surface depressions that exert a unique
describe singular acupuncture points were originally
understood as being broader functional regions of the body’s the zang organs). With the exception of the ‘benshu’ (root
anatomy (see Table 4).46 Research into the use of anatomical shu ), topographical xue regions were not named
terms within the Neijing validates this point of view. To give although their locations were noted.
one example, the anatomical term Quepen ( open basin)
is now the name of the modern acupuncture point ST-12, Principle #8
located in the supraclavicular fossa, four cun lateral to the
midline of the body.47 However, studies of how this term was
used in the Neijing shows that fourteen distinct anatomical
structures pass through the region named Quepen. Such ‘
types of analysis show that when the authors of the Neijing
used anatomical terms such as Quepen, they were most
often describing broader areas of the body’s anatomy (here .’
the region between the clavicle and scapula that demarcates ‘Gather the qi and reside within a still place. Attend to the
the opening between the thorax and the head). It was only comings and going of the shen. Shut the doors and windows;
later, as point-action theory came to the forefront, that these take care not to dispel the hun or the po. Concentrate the
descriptions were re-interpreted to become singular isolated intention, align the shen and harmonise the jing qi ( ).
acupuncture points. Be as one who cannot hear another’s voice. Gather the
Surface depressions possessing qualities roughly jing ( ), align it with the shen ( ). Align the will and the
equivalent to modern acupuncture points were described
in the Neijing. These regions were named either by the transform the shen ... This is the meaning of deqi ( ).’
generic term ‘xue’ earth cavern) or by a special case - Lingshu Chapter 9
term ‘shu’ (
Examinations of different needling techniques found within
‘ the Neijing shows that, with few notable exceptions, the
‘The qi of the foot taiyang mai vessel emerges through authors of the Neijing were not overly concerned with the
seventy-eight xue.’ concepts of point-action theory.48 For example, of twenty-six
- Suwen Chapter 59 different needling techniques described in Lingshu Chapter
7 (Guanzhen
In Neijing medical theory, a ‘xue’ is an area of surface make any mention of acupuncture point regions.49 The rest
thinning where the qi of an underlying mai vessel emerges of these passages give detailed advice on how to restore the
to the surface of the body. In contrast, the term ‘shu’ ( body’s mai vessel circulation by regulating different levels
of the body’s tissue-plane anatomy and provides strategies
( for dealing with different types of tissue-plane pathology.
the general qualities of xue depressions, but which also In classical acupuncture, it was this singular focus on the

region of the human body. For example, the ‘benshu’ (root point of all therapeutic interventions, not the activation
shu ) regions, located between the elbows and knees
therapeutic actions.50
28 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory Journal of Chinese Medicine • Number 102 • June 2013

Principle #9

).

‘ .’

of acupuncture is that its practice must be rooted in shen.”’

- Lingshu Chapter 8

‘
‘The essential thing when using the needle is never to forget
the shen.’
- Lingshu Chapter 73
( ): In the Neijing, the term
shen
The original authors of the Neijing were unequivocal about observable laws of the physical universe do not apply. When yin and
one thing, that the practice of acupuncture is based upon yang forces achieve a certain dynamic tension and equilibrium a shift
occurs that allows the light of shenming to emanate. Shenming is a
special generative force around which life processes organise themselves.
In classical Chinese, the lights of the celestial bodies and the organising
statements on this matter, few modern practitioners force of the human body are both called ‘shenming’. Because shenming
is believed to be the prerequisite for the organisation of all life, it is also
the generative force that heals and repairs the body. Shenming is carried
meaning in a clinically relevant way. As has been discussed
previously, most important terms in Chinese medicine the originators of acupuncture focused the restoration of mai vessel
circulation.[image from http://upload.wikimedia.org/wikipedia/
possess both primary and secondary meanings; primary commons/6/62/ Starsinthesky.jpg ]

manifestations of these principles.51 The special relationship In other words, most manifestations found in nature can
that exists between principle and practice is outlined in be described in terms of observable patterns of yin and
Lingshu Chapter 48: Neijing describes another
dimension of space/time that transcends the normal
‘ observable manifestations of nature; this dimension is
called ‘shen’.53 Within the Neijing various terms are used to
‘In regards to the correct method of learning, it is like tying describe different qualities of shen. Used as a singular term,
things in a bag. If a bag is full but has not been tied shut, the character ‘shen’ refers to a unique quality of space/
its contents will spill out. If a method is known but has time that transcends the normal observable laws of nature.
not been summarised into [its essential principles] it is
impossible to [understand] this method through the shen.’52 special quality of organising force that is called ‘shenming’
( shen illumination). In nature, shenming arises when
In modern TCM the term ‘shen’ ( ) is most commonly both yin and yang come into a unique state of dynamic
translated as ‘spirit’. It is a term generally used to describe tension and equilibrium. When this occurs, life processes
basic qualities of vitality and intelligence. It is also spontaneously begin to form themselves. Conversely,
sometimes used to indicate a certain ephemeral quality when the special relationship between yin and yang is lost,
between practitioner and patient that is believed to be the organising force of shenming is extinguished and the
essential for the therapeutic effect of acupuncture treatment. associated life processes cease to exist. Thus, the special
quality of shenming is seen to be a basic prerequisite for all
manifestations of the term ‘shen’ and do not describe its life processes and, as such, it is seen to contain the original
primary meaning. In contrast, in the Neijing template upon which life originally forms itself.

in the birth of stars within a stellar nebula (see Figure

description in Suwen Chapter 66: 8). As a new star begins its life, cosmic dust collects and
contracts under the prevailing contracting forces of yin.
‘ .’ As matter condenses inwards, yang forces oppose this
‘The process of a thing becoming is called hua ( ) original contraction with an outward expansion. When
transformation. The process of a thing reaching its the two oppositional forces reach a critical state, a nuclear
completion is called bian ( ) transformation. Aspects of fusion reaction occurs and a new star is born. The star then
yin and yang that cannot be measured are called shen.’ departs the stellar nebula to begin its mature life cycle as
- Suwen Chapter 66 the centre of an organised life process (i.e. a solar system).
Conversely, when the mature star reaches the end of its life,
Journal of Chinese Medicine • Number 102 • June 2013 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory 29

the star is extinguished, the solar system ceases to exist and

its elements resolve back into the fabric of space-time. Edward Neal, MD, LAc, has been actively involved in the practice
In the Neijing, the Heart is understood to be the anatomical and teaching of Chinese medicine for over 20 years. Originally trained
equivalent of the sun. As described in Suwen Chapter 8:
acupuncture with Dr. Anita Cignolini of Milan, Italy. Formerly an
Associate Professor in the Department of Classical Chinese Medicine
‘ .’ at the National College of Natural Medicine in Portland, Oregon and
founding director of the International Society for the Study of Classical
( ) emanates from it’. Acupuncture (ISSCA), Dr. Neal is currently a Senior Researcher at
the Xinglin Institute, a multi-disciplinary research and educational
Within the Neijing, mai (blood) vessels were understood institute dedicated to the study of early Chinese medical texts with
the express purpose of identifying classical treatment strategies that
to be direct emissaries of the heart. Because of this special
can be used to address a variety of global healthcare challenges. More
relationship, the governing illumination of shenming is
information about Dr. Neal and his work can be found at www.
also believed to circulate within the three-dimensional edwardneal.com.
jingluo body via the mai vessel circulation. When the mai
vessel circulation is restored during a classical acupuncture
treatment, the organising force of shenming is thus restored
to the different parts of the human body. When this occurs,
the body is able to re-form itself along the template of its Endnotes
original inception and spontaneously bring itself back 1. S e e N e a l , E . ( 2 0 1 2 ) . ‘
‘Introduction to Neijing .’ ‘The Lung
into health and balance. From the perspective of Neijing
Classical Acupuncture Part I: emerges from Shaoshang.
classical acupuncture, it was this restoration of mai vessel History and Basic Principles’. Shaoshang is located at the
circulation along with the circulation of the organising The Journal of Chinese Medicine, inner tip of the thumb. It is jing
100, pp.5-14 (well) wood ( ).’
force of shenming that was seen as the primary goal of all
classical acupuncture treatments, and in classical terms
2. Perhaps one of the most In Neijing terminology, wood
these processes were understood to underlie the therapeutic ( ) and metal ) are terms
of Neijing medical theory found used to describe different
in the Nanjing concerns the qualities of circulation and
primary role of the benshu
Summary ( ) point regions. In the circulation describes motion
Neijing classical acupuncture is a sophisticated form of Neijing, the benshu regions are that expands outwards and

areas located distal to the the heavens. Metal circulation

circulation through the entire three-dimensional tissue elbows and knees that have a describes motion that contracts
planes of the human body. Its clinical practice is based upon
zang organs. These regions heavens to the earth. Within
a deep understanding of the innate patterns of nature and were identified using the these passages the Neijing uses
an in-depth knowledge of human anatomy and physiology. sequential nomenclature jing
well), ying ( rivulet), to indicate to the reader: a)
As originally described, Neijing classical acupuncture had shu ( influence region), the location of the origin (or
little to do with point-action theory, which constitutes the jing ( channel) and he terminus) of a given mai
( convergence). On yang vessel pathway (i.e. the jing
main theoretical framework of most modern acupuncture
pathways, an additional well region) and b) the
practice and education. As originally described, Neijing region was defined as the primary direction of the mai
classical acupuncture was a physician-level skill indicated yuan ( source) region (on vessel circulation (i.e. yang
yin pathways the yuan-source mai vessels have a descending
for the treatment of critical and life-threatening illnesses. regions are synonymous with or ‘metal’ circulation, and yin
Although many of the original principles of acupuncture the shu [ ] regions). In Lingshu vessels have an ascending
practice have now been forgotten, these theories and Chapter 2 (‘Root Shu’) the or ‘wood’ circulation). Later
text passages that describe in the Nanjing, these terms
practices were written down and remain accessible today these regions all begin with a
through research and study. The information contained description of a jing-well region )
followed by the qualifying term
‘wood’ ( ) or ‘metal' ( ). For a yin channel is a ‘wood point’,
the practice of Chinese medicine and make valuable example:
contributions to a wide variety of global healthcare issues.
is a ‘metal point’, the second
‘ point is a ‘water point’ etc.). This
.’ ‘The Stomach
clinical treatment. in turn became the theoretical
emerges from Lidui. Lidui is basis for a variety of different
located lateral to the big toe at schools of acupuncture (e.g.
the inner tip of the second toe. different schools of Japanese
It is jing (well) metal ( ).’ acupuncture, Worsley-style
five element acupuncture
Similarly, for a corresponding etc.) and became a basic tenet
yin pathway we see a of modern TCM education.
comparable passage: However, this interpretation
30 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory Journal of Chinese Medicine • Number 102 • June 2013

contradicts basic five phase principles set down within the and Los Angeles: University of 14. During the Song Dynasty,
theory: In five phase theory original source texts (roughly California Press. official bureaus for medical
wood and metal represent two 220 CE-1911 CE); 3) Post-1949 9. As noted in Part I of this administration, medical
intermediate circulations that medicine in China, in which article, medical texts such education and medical editing
exist between the opposing two combined Western medicine/ as the Lingshu most likely were established. It was during
) and water ( TCM training programs for represent composites of pre- this time that imperial medical
they do not describe qualities of Chinese medicine physicians Han and Han classical texts
motion that occur at the origins of were developed; and 4) Post- that survived the Qin Dynasty with the Imperial College that
these circulations. Further, these 1949 medicine in the West, in literary purge. These were oversaw the national education
interpretations do not correlate which the exported amalgam likely compiled, re-compiled system.
with the way that these terms of TCM was taught and spread and added to by scholars of
were used in the source material. throughout the world. subsequent dynasties until
For example, in the Neijing it is 15. For a general overview of the
consensus editions emerged medical changes that occurred
clearly stated that all jing-well that then became part of the
regions of the body correspond 4. In Chinese medicine, the during the Song Dynasty see
term ‘classical’ is a somewhat canon of medical literature; for Goldschmidt, A. (2011). The
with the season of Winter (and more on this issue see Neal, E.
thus the Northern direction and confusing term that is used in Evolution of Chinese Medicine:
a variety of ways. Historically, (2012). ‘Introduction to Neijing Song Dynasty, 960-1200. London
the phase of water). This also Classical Acupuncture Part I:
follows logically from yinyang this term is used to describe the and New York: Routledge
chronological period starting History and Basic Principles’. Curzon.
theory (jing-well regions are The Journal of Chinese Medicine,
the areas of the body where somewhere prior to the Zhanguo
(Warring States) period of 100, pp.5-14.
mai vessel circulations either 16. These advancements were aided
terminate their existence or have the Eastern Zhou Dynasty to
the end of the Eastern Han by the invention of movable type
their origin (i.e. the Lung mai 10. It is also possible that the print by Bi Sheng in 1040 CE.
Dynasty (approximately 500 Needling Classic was referenced
at the Lung jing-well region, the BCE-220 CE). Various schools of - although not by name - in
Large Intestine mai vessel has acupuncture also use this term Ban Gu’s inventory of the Han 17. During the latter half of the Qing
its origin at the Large Intestine to distinguish their practices imperial library undertaken in dynasty (1644-1911CE) there
from modern ‘TCM-style’ was a general deterioration of
phase theory, the Winter season acupuncture. It is also used account, a reference is made to societal conditions caused by
is the time of both terminal loosely to indicate ‘the ancient eighteen rolls (juan) of a Huangdi epidemics, natural disasters,
cessation of life and embryonic art of Chinese medicine’. For Neijing Suwen. It is possible that civil strife (upwards of 20
origination. Thus, the original the purposes of this article the million people died during the
descriptions found within the term ‘classical’ is used in two Suwen and the second nine to Taiping rebellion alone), the First
Neijing not only correspond distinct ways. Firstly, it refers to a Needling Classic. and Second and Opium Wars,
with observable laws of nature various foreign occupations
but are also consistent with basic as described above. Secondly, and the Boxer Rebellion.
it is a used to describe a set 11. According to Huang Fu Mi, A significant proportion of
of clinical practices based on the Zhenjiu Jiayi Jing (Systematic China’s citizens lived in abject
Practitioners of Nanjing-based
Warring States and Han Dynasty Classic on Acupuncture and poverty and severely unsanitary
styles may counter by citing
medical texts that utilise the Moxibustion) was a compilation conditions. Given the basic
theories of yinyang directional formed from three primary texts, standard of living experienced
demonstrate the effectiveness of
science (see the rest of this article the Suwen (Plain Questions), by the average individual, it is
a particular system. However,
for explanation). Zhenjing (Needling Classic) and perhaps understandable why
because the benshu regions exert
Mingtang Kongxue Zhenjiu policies aimed at modernisation
Zhiyao (Essentials on Needling and against traditional practices
the internal organs of the body, 5. Although other descriptions of and Moxibustion of the Illuminated were advocated.
they were recognised as being acupuncture practice existed in Chamber), the latter of which has
some of the most clinically texts such as the Mawangdui been lost.
medical manuscripts, these 18. See Taylor, K. (2005). Chinese
any type of treatment given in descriptions do not provide the Medicine in Early Communist
these regions would be expected level of detail found within the 12. Lu, Gwei-djen & Needham, J. China, 1945-1963: A Medicine of
to produce some sort of clinical Lingshu. (2002). Celestial Lancets: A History Revolution. (Needham Research
results. Here, the question is not and Rationale of Acupuncture and Institute Series). London:
whether these areas are clinically Moxa. London and New York:
6. This distinction is not absolute; Routledge Curzon
significant, but rather what Routledge.
might be the effects of therapy the Neijing Suwen also contains
if these regions were used as a number of passages related to 19. The term ‘TCM’ was first
originally described within the acupuncture practice, and the 13. These bronze statues were used in the Chinese Medical
classical source texts. Neijing Lingshu contains many constructed with passageways Journal in 1955 – a journal
passages related to basic medical that were filled with liquid. published primarily for non-
theory. Chinese readers. There exists no
3. For general purposes, the recognised acupunture comparable term in the Chinese
evolution of Chinese medicine points and sealed with wax.
7. To avoid confusion, in this language. In modern China,
can roughly be divided into four To successfully pass their
article, all of the different names Chinese medicine is simply
basic phases of development: examinations, students were
of the Lingshu family of texts will known as zhongyi ( Chinese
1) The period of the Warring required to insert needles at
be referred to either by the title medicine).
States and Han Dynasty, during pre-determined locations, thus
which the first principles of ‘Lingshu’ or by the more generic
acupuncture practice and term ‘Needling Classic’. point. Concurrently with this, 20. These were the programmes
Naturalist philosophy were Wang completed a three-volume known as Xiyi Xuexi Zhongyi
first set down (475 BCE-220 (‘Western Doctors
8. For more on the history of the
CE); 2) The post-Han Imperial of acupuncture points entitled Study Chinese Medicine). For
Lingshu text see Sivin, N. ‘Huang
period, during which a Tongren Shuxue Zhenjiu Tujing further analysis see Taylor,
Ti Nei Ching ,’ in Loewe,
variety of different theoretical (Illustrations of the Bronze Man K. (2005). Chinese Medicine in
M. ed. (1993). Early Chinese Texts:
schools arose from the basic Acupuncture and Moxibustion Early Communist China, 1945-
A Bibliographical Guide. Berkeley
Points). 1963: A Medicine of Revolution.
Journal of Chinese Medicine • Number 102 • June 2013 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory 31

(Needham Research Institute oedema. Similarly, from Lingshu passes along the inner aspect of their theoretical conception.
Series). Routledge Curzon. Chapter 9: Thus, while some aspects
its tip.’ of the classical description

21. For example, Nanjing Academy ‘

modern description, they were
of TCM (ed.) (1958). Outline of 30. At the time of the Neijing the theoretically and conceptually
TCM . Beijing: .’ ‘In shaoyang structures of the human body different. That this is so should
Renmin weisheng chubanshe, death there is deafness and a were studied through medical not be surprising. In fact, the
and Health Unit of the Logistics loosening of the one hundred dissections and were observed description of human blood
Department of the Guangzhou joints. The system of the eyes in battlefield medicine and circulation posed a particularly
Army (ed.) (1972). Revised is exhausted. When the system the various medical situations thorny scientific problem in
Outline of TCM of the eyes is exhausted, in one found in agrarian life. the West. It was not until 1628
. Beijing: Renmin Weisheng and a half days the patient dies.
when William Harvey wrote
Chubanshe. When the complexion turns pale
31. While classical texts such as Exercitatio Anatomica de Motu
blue-green and white, the person
the Neijing can be complex, Cordis et Sanguinis in Animalibus
will die.’
22. For more see Fruehauf, H. multi-layered documents open (Anatomical Exercise on the Motion
(1999). ‘Chinese Medicine in to interpretation, the concept of the Heart and Blood in Living
Crisis: Science, Politics and Such conditions will be seen that mai vessels represent blood Beings) that Western physicians
the Making of TCM’. Journal of in hospice care when a dying vessels is not ambiguous. The had an accurate description of
Chinese Medicine, 61, 6-14. patient becomes obtunded, word ‘mai’ itself means ‘blood blood circulation.
develops flaccidity and vessel’, the role of mai vessels is
nystagmus. to ‘carry the blood’, the stirring
23. For a current list of acupuncture 35. In Chinese medicine, a lack
of mai vessels describes the of understanding as to the
indications recommended by
pulsation of arteries, mai vessels nature of mai vessels poses a
the World Health Organisation 27. It is also true that bad traditional are seen as a direct extention variety of theoretical problems.
medical practices have persisted of the heart, the act of taking a
medicinedocs/en/d/Js4926e/5. over time, so it is critical that For example, in Chinese
pulse literally translated means medicine education, students
html.> [accessed 13/05/2013] classical medical techniques ‘to assess a mai vessel’ etc. are routinely taught that ‘blood
are also evaluated and tested in
a manner similar to any other is the mother of qi’ (
24. In modern China, the majority of medical therapy. ) and ‘qi is the commander
32. Within the Neijing no qualitative
hospital-based therapies involve of blood’ ( ). Such
distinction is made between
the prescription of herbal sayings have little meaning if
arteries and veins, both are
formulas. In these settings, 28. Some descriptions of mai the acupuncture channel system
described under the term ‘mai
acupuncture is typically viewed vessel circulation and pathology is understood as being a series
vessel’.
as an auxiliary form of therapy found in the Lingshu show a of disembodied circulation
indicated for the treatment striking resemblance (or are pathways. However, if the
identical) to descriptions found 33. The idea that the term ‘mai’ original acupuncture pathways
pain syndromes, post-stroke within the Mawangdui medical represents blood vessels is are understood to be mai vessels,
paralysis, migraine headaches manuscripts, suggesting that not new, it has simply been such statements have a clear
and Bell’s palsy, etc. these two texts at least partially unused and forgotten. In fact, and definite meaning with
share a similar origin, or until the latter half of the strong and immediate clinical
evolved within parallel medical twentieth century, authors implications.
25. Although herbal therapies traditions. such as Joseph Needham and
were known at the time of the
others wrote clearly about these
Neijing, few prescriptions were 36. The descriptions of mai vessel
relationships - see Lu, Gwei-Djen
29. The full passage reads: ‘ & Needham, J. (2002). Celestial circulation also make a direct
prominently within the text. and tangible bridge between
Lancets: A History and Rationale
of Acupuncture and Moxa. London Chinese medicine and Western
and New York: Routledge. biomedicine in a way that does
26. For example, from Suwen
not undermine or weaken the
Chapter 61:
original theoretical observations
.’ ‘The 34. In the discourse of Chinese of Chinese medicine or classical
‘ lung hand taiyin mai vessel medicine, it is an oft-heard Naturalist philosophy.
.’ arises at zhongjiao middle phrase that acupuncture
‘With regards to water diseases: burner]. Descending, it nets with channels specifically do not
the large intestine. Turning back describe the circulation of blood. 37 As one example, in the classical
within the lower body there will
it crosses weikou stomach For example, it is commonly description of blood circulation
be swellings within the fu organs
mouth]. Crossing the diaphragm noted that modern acupuncture it is the Lungs not the Heart that
and distention of the abdomen.
it joins with the lungs. From the channels do not follow the moves the blood circulation.
When the upper body is affected
network of the lungs it passes course of the vascular pathways
one cannot lie down. Here, both laterally to emerge from beneath of the human body. However, 38 In Chinese medicine, the tidal
the outer manifestation and the the axilla. Descending it follows these arguments ignore basic variations of the mai vessel
root have been affected by the the inner aspect of the arm historical facts: a) The mai circulation are often erroneously
same illness. Therefore, [water crossing in front of shaoyin [ vessel pathways described in the described as being a ‘Chinese
diseases] when within the lungs lesser yin] and xinzhu [ Neijing medicine organ clock’. In
heart ruler]. Crossing through altered since their original actuality, the diurnal circulation
within the kidneys cause water the elbow it crosses the inner descriptions. In fact, many of represented in these depictions
swellings.’ aspect of the forearm and moves the original pathways described portrays the 24-hour tidal
beneath the edge of shanggu [ within the Neijing coincide variations within the body’s
upper bone]. Entering cunkou closely with known human mai vessel circulation – not the
Such a description might [ inch mouth], it ascends yu vascular pathways. b) The circulation within the internal
be recognised by a Western classical description of blood organs themselves. According
medicine-trained physician as circulation differs from the to the Neijing, the zang internal
right- and left-sided heart failure of the thumb. A [second] branch modern description because organs represent the deepest
with ascites and pulmonary divides behind the wrist and these two systems differ in depots of seasonal/directional
32 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory Journal of Chinese Medicine • Number 102 • June 2013

jing ( essence). As such, they classical the anatomical medical theory, it has become anything we consider soiled. The
are always associated with the structures that are most closely a somewhat common practice sensitivity of the lungs to insult
five cardinal directions and associated with the concept to attempt to construct is such that people with weak
their corresponding times (e.g. of the modern acupuncture theoretical approaches to lungs often feel tainted in life or
the Kidney always corresponds channel. acupuncture based on elaborate like they are ‘damaged goods’.
to the direction of the North interpretations of point name However, virtue lives purely
and the time of midnight, the symbolism and the concepts of within each of us untouched by
Lungs always correspond to the 43. The term ‘luo’ ( ) is also used point-action theory. Although any event in life. In fact, heaven
direction of the West and the time possibly well intentioned, these can only ever see the highest in
of sunset etc.). In contrast, the which mai vessels communicate attempts often stand directly at us. For only the virtue we have
diurnal tidal circulation of the with internal organs, when they odds with basic classical medical cultivated during life ascends
Kidney mai vessel (for example) make a ‘netting’ or ‘web-like’ theory. To give one example; to heaven upon death to join
is understood to be particularly connection. Tianfu ( heavenly palace) the light of the moon, stars and
strong during the two-hour time is currently the name of the sun ... This point may truly
period of you 44. For example see Gray, E. (2010). modern acupuncture point enable us to forgive, let go of
and seven o’clock in the evening Jingshui and the Rivers of Ancient LU-3 located three cun below the past, and be receptive to the
and the circulation of the Lung China. Master’s Thesis. National the axillary fold on the radial guidance of divine inspiration
mai vessel is understood to be College of Natural Medicine aspect of the biceps brachii so we can move ahead in life
strongest during the time of Library. Portland, Oregon. tendon. However, as originally less burdened.’ - from Jarrett,
yin described, Tianfu was seen as L. (2003). The Clinical Practice of
o’clock in the morning. Here, being a broader anatomical zone Chinese Medicine. Stockbridge,
two separate chronobiological 45. Although not entirely consistent found along the taiyin Lung MA: Spirit Path Press, pp.575-
systems are basically confused with contemporary Western mai vessel pathway where the 576.
– one based on the circulation of anatomical descriptions, Neijing vessel exits the chest at the region
the internal zang organs (which anatomical descriptions add of the stirring of the axillary
associates with the primary valuable information related artery (now the location of the Or:
cardinal directions and their to the form and function of modern point Jiquan HE- 1).
corresponding seasonal times) the human body by including The Lingshu gives us a relatively ‘[The point] Tianfu ... expresses
and one based on mai vessel tidal descriptions of how the body straightforward description of the functional dynamic of the
circulation (which describes the performs and is experienced this region: number three. Zhongfu, Lu-1
varying degrees of tidal strength at rest and in motion and how
represents the taiyin source in
within the human mai vessel the body responds to different
’ the state of heavenly oneness,
circulation over a 24-hr period). types of impairment and clinical
‘The stirring mai vessel within where the ore of the lung metal
In modern Chinese medical therapy. In contrast, Western
the axilla is the hand taiyin mai is still concealed within the
education, these two systems anatomical descriptions are
vessel. Its name is ‘Tianfu’.’ womb of the earth. Yunmen
are often poorly understood. primarily static, describing
LU-2 introduces the emergence
different structures of a non-
of lung qi at the border between
living body. In the Neijing, Tianfu describes
39 See Neal, E. (2012). ‘Introduction lung heaven and spleen earth,
to Neijing Classical Acupuncture an important anatomical region in the form of earth/metal
Part I: History and Basic 46. The benshu ( root shu) that resides at the demarcation amalgam. Tianfu
Principles’. Journal of Chinese regions of the extremities being zone between the upper and represents the taiyin essence in
Medicine, 100, pp.5-14. the most notable exception. lower regions of the body (hence its pure metal state – ready to be
its name ‘heavenly palace’). used for ceremonial purposes
To a classical acupuncturist, at the imperial court, ritually
40 Ibid. 47. Deadman, P. Al-Khafaji, M. & this area would have been of imbuing the kingdom with the
Baker, K. (2007). A Manual of substantial importance because promise of material splendor
Acupuncture Hove: Journal of it is located at the outflow ... [Tianfu] conjures up images
41 In the Neijing, any circulatory Chinese Medicine Publications. source of the Lung mai vessel of an ancient Shangri-La, a
pathways that flowed
circulation. In turn, the Lung central paradise surrounded
horizontally from the interior
mai vessel circulation resides by beautiful sites in all four
to the exterior surface of the 48. Point-action theory is the
at the headwater source of the directions ... [Tianfu] is typically
extremities were called ‘luo’ theoretical foundation of most
entire mai vessel circulation of described as ‘the land where
pathways. This included modern TCM acupuncture
the body. Thus, any impairment fertile earth, arable lands,
descriptions of what are now practice. In this system, an
here can potentially cause a prosperous people and exquisite
understood in Western medicine acupuncture point is understood
disturbance in the mai vessel chariots abound ... a Heavenly
as being peripheral capillary
circulation of the entire body. In Treasury with taiyin attributes
beds. In Neijing theory, these effects that are ‘activated’ when
contrast, others have a great deal
areas were understood to be the point is correctly needled.
more to say about the unique facilitate the connection to a male
important potential reservoirs
qualities of the point ‘Tianfu’, ancestor in Heaven, who is really
of chronic disease and important
49. The two primary exceptions for example: the swarthy Earth Mother in
pathways traversed by external
are the use of the benshu ( ) heavenly guise... where common
pathogens. In TCM theory, the
point regions to treat disorders postnatal wine is upgraded to
meaning of the term ‘luo’ is ‘Lu-3 ‘Heavenly Palace’
of the internal zang organs, and the noble, champagne-like elixir
now most often truncated to Tianfu ... The pathology of of life ...’’ - from Fruehauf, H.
simply refer to the region of the the metal element is that once
regions to treat disorders of the (2002). ‘The Science of Symbols:
‘luo point’ – one small subset inspiration and self-worth are
fu organs. Exploring a Forgotten Gateway
within the larger concept of ‘luo’
to Chinese Medicine (Part Two)’.
pathways. the worst in ourselves and The Journal of Chinese Medicine, 69
others. The lungs’ virtue of pp.20-26.
connecting to essence is thus
42. Jing ( ) longitudinal fascial 50. Perhaps, due to a basic These are just a few examples
distorted into perfectionism
circulation pathways represent misunderstanding of Neijing from two well-known
and disdain for anyone or
Journal of Chinese Medicine • Number 102 • June 2013 Introduction to Neijing Classical Acupuncture Part II: Clinical Theory 33

proponents of this style of Here, both examples attempt to innate difference in competency
thinking, many other such impart a sense of theoretical and or job skill. Rather, it refers
examples of this type of
approach can be found within borrowing from the concepts education and an approach
the profession of Chinese of popular psychology and to clinical thinking in which a
medicine. new-age spirituality, the second practitioner is able to deal with
While it is true that, especially by invoking multiple images of clinical complexity through
in Pre-Han China, written poetic symbolism. Both infer a an understanding of basic
character glyphs were connection to classical medicine principle. In contrast, auxillary
understood to have supra- and the original ‘spirit’ of healthcare primarily functions
linguistic meanings and carry Chinese medicine; both fail to on a system of basic algorhythmic
a degree of talismanic power, convey a basic understanding of pattern recognition. From this
being direct representations classical Chinese medical theory. perspective, most contemporary
of the basic patterns of nature, Most importantly, the Huangdi Chinese medical practice can
interpretations such as these fail Neijing and other classical be seen to exist as a type of
on multiple levels to accurately medical texts were not written auxilliary healthcare that is
convey basic concepts of classical as treatises on contemporary currently not being practised at
medical theory or provide psychology, nor were they a physician level of care.
clinically relevant information. written with the intention
Just a few of the inaccuracies of being read in the style of 52. The full passage reads:
found within these brief classical poetry (a style in
passage include: a) Originally which complex symbolism and
the name Tianfu did not refer hidden context are an accepted
part of the literary genre).
on the modern Lung channel. Instead, the Neijing and similar ‘In regards to the
Rather it described an important correct method of learning, it
anatomical zone located within and foremost medical texts is like tying things in a bag. If
the axilla; b) Tianfu was not written by clinical practitioners a bag is full but has not been
originally ‘the third point on tied shut, its contents will spill
the Lung channel’, because medical information to future out. If a method is known but
points were not numbered in generations. In the opinion of has not been summarised into
this way; so any mention of the author, two basic possibilities [its essential principles] it is
such numerical symbolism in exist in relation to the practice impossible to [understand]
this context is spurious; c) The of Chinese medicine: either this method through the shen.’
names Zhongfu and Yunmen Chinese medicine represents Lei Gong said, ‘What of those
were not classical point names an authentic and valuable of lesser ability who tie their
mentioned in the Neijing at all medical practice which should bags before they are full?’
but rather came into existence be preserved and studied, or it The Yellow Emperor said,
in later dynasties; and d) Tianfu represents an elaborate type of ‘Those whose bags are not full,
was originally described as placebo. If it is the former, then yet expound their knowledge
being located in the region of the the basic principles and theories anyway, believe themselves to
pulsation of the axillary artery of the medicine matter greatly
(now the area of the modern and it is crucial to understand
point Jiquan HE-1). Therefore, if them and get them right. If
a modern practitioner chooses to however, Chinese medicine
needle the modern point Tianfu exists only as an elaborate type 53. In 1905, a Swiss patent clerk
( ) LU-3 for the indications of placebo, where any type named Albert Einstein made
listed above (for example to of theory can be found valid, a similar observation in his
activate ‘luminous objects that then ultimately it is not worth paper ‘Zur Elektrodynamik
facilitate the connection to a much collective time or effort bewegter Körper ’ (‘On the
male ancestor in Heaven’, or to (except perhaps as a study Electrodynamics of Moving
‘enable us to forgive, let go of of the phenomena of placebo Bodies’), in which he described
the past, and be receptive to the medicine). Perhaps the time his theory of general relativity
guidance of divine inspiration’), has come in the evolution of and the changes that the
they are in actuality treating Chinese medicine when it is physical universe undergoes as
an area that was originally now acceptable to question phenomena approach the speed
described as being located what constitutes appropriate of light.
on the Large Intestine mai levels of scholarship and hold
pathway not the Lung mai investigators accountable to
pathway. Further, with few basic levels of research.
exceptions, the clinical practice
of Neijing classical acupuncture
did not rely on point-action 51. In clinical medicine this
theory; therefore attempts distinction becomes critical,
to construct overly-wrought because it is through an
descriptions from the symbolic understanding of principle
interpretations of acupuncture that a demarcation is made
point names are inconsistent between physician and non-
with the way these regions physician levels of care. Here
were originally understood or the term ‘physician’ does not
used in the classical source texts. refer to any type of licensure or
training, nor does it describe an