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                                                            The merging
                                                            of ways
An approach to understanding the channel
divergences in meridian style therapy




By Charles Chace                                                                 pathways for hyper or hypo tonicity, or per-
                                                                                 haps through the sensation of the propaga-
                                                                                 tion of qi along a channel when a point on
Those who know heaven and know humankind are there. Those                        its trajectory has been needled. We also have
                                                                                 a variety of indirect means of assessing in-
who know heaven know heaven gives one life. Whoever knows
                                                                                 fluence though changes in the pulse, tongue
humankind uses knowing to nurture what cannot be known.                          and abdomen; but what about the rest of the
They will run out the string of their years and not find it cut off               channel system?
in the middle. This is the fullest knowledge. And yet, though                      Our influence on those facets of the chan-
                                                                                 nel system more closely allied to superficial
this is so, there is a problem: knowledge waits on certainty, but                anatomical structures such as the channel
certainty is never quite certain.                                                sinews (jing jin         ) and the network ves-
                     – Zhuangzi Chapter 6: The Great Ancestral Teacher           sels (luo mai        ) is probably best assessed
                                                                                 in two ways, The first is through relatively
                                                                                 local changes in the quality of tissues under-
                                                                                 lying an effected area that has been directly
                                                                                 treated and the second is through some very

                              A      CUPUNCTURE is commonly believed
                                     to be something of a black box. We in-
                              troduce a stimulus and it has an effect, yet
                                                                                 general improvements in the quality of the
                                                                                 pulse. By and large, we know that we have
                                                                                 had an effect on these channels because we
                              it is often difficult to say why it has worked.     literally feel it under our hands.
                              We have a variety of tools that help us navi-        The subtlety of these issues increases sig-
                              gate this void, the theoretical structure of the   nificantly when it comes to what many con-
                              channel system being the most prominent            sider the deepest facets of the channel sys-
                              among them. Many of us have some tangi-            tem, the channel divergences (jing bie         )
                              ble experience of the primary channel sys-         and the eight extraordinary vessels. Both of
                              tem, perhaps through palpating the channel         these channel systems are typically activated

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                                                                                                     ‘’
using pairs of acupuncture points that are       what the text said and how it was interpret-
located on the primary channels. This poses      ed by virtually all the modern sources that
an immediate challenge to clearly differenti-    I looked at. Subsequent writers had clearly
ating the influence of a putative channel di-     bridged this gap with a great deal of creative
vergence or extraordinary vessel treatment       interpretation of their own and this was an      One passage in particular,
from the more mundane primary channel            aspect of the channel system that was cov-
                                                                                                  a recapitulation of the
influence of those two points. The problem        ered in virtually all basic textbooks of acu-
is particularly germane to the channel diver-    puncture.
                                                                                                  section on the channel
gences where the source literature provides        At around this time I made the acquain-        divergences from Chapter
no specific methodology for activating them       tance of Miki Shima, a Japanese acupunc-         11 of the Divine Pivot,
and there are many different modern ideas        turist living in Marin County in California,     would haunt me for years.
as to how they should be used.a This essay       who had made an extensive study of the
is an exploration of my attempts to mean-        secondary vessels. He generously provided
ingfully apply the channel divergences in        me with enough insight to turn out a pass-
my own clinical practice and to develop a        able translation, but how one might actu-
model for verifying that I have actually ac-     ally use the channel divergences remained a
cessed them.                                     mystery to me.
  In the late 1980s I collaborated with Yang       My initial exchange with Miki regarding
Shou-Zhong on a translation of Huangfu           the channel divergences ultimately led to a
Mi’s           , Yellow Emperor’s Systematic     long and productive friendship, and by the
Classic of Acupuncture and Moxibustion           mid 1990s we decided to collaborate on a
(Huang Di Zhen Jiu Jia Yi Jing                   book project. Given our mutual interest, the
        , 3rd century) As the name implies,
              century).                          channel divergences were an obvious topic
the book is a systematic reorganisation of       for us. In this book we reviewed many ap-
earlier material from the Ling Shu, Su Wen,      proaches to channel divergence therapeutics
the Tai Su and a few other now lost texts,       culminating in Shima’s own considerable
and it constitutes the first real textbook of     experience with them.
acupuncture practice.                              Among the most satisfying aspects of that
  Although I was most decidedly the junior       project for me was the opportunity it pro-
member of the translation team, the project      vided for revisiting Chapter 11 of the Ling
was a pivotal point in my development as a       Shu. This afforded me a context for once
student and practitioner of Chinese medi-        again grappling with the issue of how one
cine. At that time my work on the Jia Yi Jing    makes that pivotal leap from text to prac-
provided me with an in-depth exposure to         tice. Many of the channel divergences are
the contents of the Su Wen and Ling Shu          described as traveling along the trajectories
and it consolidated my love of pre-modern        of their associated primary channels in a
medical literature even as it drove home         direction but opposite to their usual flow.
how challenging texts such as this can be to     They therefore present some significant in-
meaningfully interpret. Many of its passages     terpretive problems. The more I studied the
were completely opaque to me and I had no        channel system, the closer I came to a con-
idea what relevance they might have to my        ceptual crisis. There were so many of these
own practice of acupuncture. One passage         apparent paradoxes that I began to won-
in particular, a recapitulation of the section   der whether the ancient Chinese actually
on the channel divergences from Chapter          thought of the channels and networks as
11 of the Divine Pivot, would haunt me for       tangible and “real” or were they just handy
years.                                           ideas they used when it suited them?             n Charles Chace has been a
  The section on the channel divergences           My subsequent readings on early Chinese        student of Chinese medicine
was the first place in our work on the Jia        epistemology and ontology suggested that         and its literature for over 25
Yi Jing that truly bothered me. Although         the compilers of the Nei Jing had a funda-       years. He graduated from
the grammar was clear enough, and Profes-        mentally different approach to reality than      the New England School of
sor Yang did his best to explain his under-      we do today. Where their contemporary            Acupuncture in 1984. He is the
standing of the passage to me, I remained        Greek counterparts were beginning to ask         author and translator of a vari-
doubtful that we had any idea what it really     the questions concerning the nature of real-     ety of books and maintains a
meant. Moreover, there was chasm between         ity that would define the course of Western       clinic in Boulder, Colorado.


                                                                                                         The Lantern          15
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  ‘’
                              thought for the next two millennia, these       regarding the function and influence of the
                              questions were of little interest to the Chi-   channel divergences that were so fantastic I
                              nese. During this time in Chinese history, a    found them quite literally unbelievable.
                              thing was considered real if it led to effica-     Could all these really be different inter-
By and large, the senior      cious action. They were less concerned with     pretations of the same phenomena? In more
meridian therapists I have    what a thing was than how it could used.        pragmatic terms, were these disparate meth-
                              This conceptual distinction has been de-        ods all simply various expressions of “how
met have little interest in
                              scribed as a “how priority attitude” as op-     priority attitude”? There was no question in
the channel divergences.      posed to a “what priority attitude”b. Such a    my mind that Miki, my channel divergence
                              perspective helps to explain how the com-       mentor, was satisfied that he was accessing
                              peting and mutually contradictory theories      the channel divergences, and I had seen his
                              of yin/yang and the five phases could co-        remarkably effective use of strategies that he
                              exist. Each was efficacious in a given set of    labelled as channel divergence therapies in
                              circumstances. It also helps to explain how     his clinical practice. Similarly, it was clear to
                              qi could be conceptualised as moving in         me his teachers Tadashi Irie and Seki truly
                              opposite directions in the same channel. Qi     believed they were indeed executing chan-
                              might flow in different ways under different     nel divergence treatments. I was even will-
                              circumstances. From that point on I began       ing to give some of the European theorists
                              to sift my understanding of the classical       the benefit of the doubt that they too were
                              medical literature through the filter of what    indeed accessing the channel divergences
                              I imagined a how priority attitude might be,    even though I believed that many of their
                              but I had not focused this perspective on a     fundamental premises were based on a tex-
                              critical examination of my own practice.        tual misinterpretation.
                                Around the time our channel divergence          In my own practice, some of these ap-
                              book went to press, I had lunch with Jeffrey    proaches most definitely worked better for
                              Dann, a friend and colleague with whom I        me than others and many failed my per-
                              share an interest in palpation based styles     sonal test of efficacy. Clearly, no one else’s
                              of acupuncture, particularly those from Ja-     firmly held conviction would ever be suf-
                              pan. He quite innocently asked me if I re-      ficient to dispel my own uncertainty, and
                              ally thought that the channel divergences       it was up to me to define my own criteria
                              were an effective means of treatment. My        for what constitutes a channel divergence
                              knee-jerk response was an unqualified and        treatment. When does any acupuncture
                              effusive endorsement of the channel diver-      intervention become a channel divergence
                              gence strategies. True, I did have a vested     treatment and how do I know that I have
                              interest in that answer. I had spent the pre-   been effective?
                              vious four years researching the channel          The following discussion assumes a cer-
                              divergences and I had a book coming out         tain familiarity on the part of the reader
                              on the topic. Of course I was sure that they    with both the essentials of meridian style
                              worked! Jeffrey nodded politely the way         therapy and with some of the fundamen-
                              one does when one discovers one has unin-       tal concepts associated with the channel
                              tentionally trod on delicate ground and our     divergences. Those interested in a compre-
                              conversation turned to other things … but       hensive discussion of meridian therapy will
                              he had planted an insidious seed.               find Shudo Denmei’s excellent Japanese
                                At that point I had been exposed to a wide    Classical Acupuncture, Introduction to Me-
                              range of perspectives on channel divergence     ridian Therapy (1990) informative. Those
                              treatment from both Asia and Europe, each       interested in a more thorough introduction
                              of which was based on differing assump-         to channel divergence therapeutics will find
                              tions regarding nature and topology of the      Channel Divergences, Deeper Pathways of
                              channel divergences. Some of these strate-      the Web by Miki Shima and Charles Chace
                              gies were Byzantine in their complexity,        (2001) of interest.
                              while others were remarkably simple. Al-          For the purposes of this essay, however,
                              though the Japanese sources limited their       some of the key ideas concerning channel
                              scope of interest to relatively tangible and    divergence therapy are summarised in the
                              practical applications, others made claims      following tables.

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 Central characteristics of                        A basic channel divergence treatment model
 the channel divergences                           Channel       Master point      Source          Network        Uniting
                                                   LU            ST-12             LI-4            LI-6           LI-11
 n The channel divergences are the primary         LI            ST-12             LU-9            LU-7           LU-5
 and deepest internal pathways of the chan-        P             GB-12             P-7             P-6            P-3
 nel system.                                       SJ            GB-12             SJ-4            SJ-5           SJ-10
 n The channel divergences are arranged in         HE            BL-1              HE-7            HE-5           HE-3
 yin-yang pairs referred to as confluences         SI            BL-1              SI-4            SI-7           SI-8
 ( he).                                            SP            ST-1              SP-3            SP-4           SP-9
 n The channel divergences directly link the
                                                   ST            ST-1              ST-42           ST-40          ST-36
 core with the exterior and exterior with the
                                                   LIV           GB-1              LIV-3           LIV-5          LIV-8
 core.
                                                   GB            GB-1              GB-40           GB-37          GB-34
 n All channel divergences move upward and
                                                                 BL-11
 ultimately outward in the body.                   KID                             KID-3           KID-4          KID-10
                                                                 BL-1
 n All channel divergences terminate in the
                                                                 BL-11
 face/neck.                                        BL                              BL-64           BL-65          BL-40
                                                                 BL-1
 n All confluences directly or indirectly pass
 through the heart/chest.                         The above table summarises some of
 n Channel divergences provide a direct con-      the most common choices for channel
 nection between the yuan, ying and wei qi.       divergence pairings.
 n European sources emphasise wei qi/net-           This pairing of distal points on the ex-
 work vessel relationships.                       tremities with an associated master point
 n Japanese sources emphasise ying qi–yuan        on the head is the basis for all channel di-
 qi/zang fu relationships.                        vergence strategies that I have found to be
                                                  effective.
                                                    As such, it is my criteria for defining chan-
                                                  nel divergence activation.
  Fundamental treatment                             After six or seven years of actively ori-
  premises                                        enting my acupuncture practice around
  n Most channel divergence treatment strate-     combinations of channel divergence and
  gies require two points, a “master” and a       extraordinary vessel treatment strategies, I
  “couple”, to activate them.                     realised that I had been consistently over-
  n The master points are located on the head     looking the primary channels. Since my ul-
  and neck.                                       timate goal was to maximise my use of the
  n Shima’s interpretation is that these cepha-   entire channel system of which the chan-
  lad points must be paired with the he conflu-   nel divergences are only one part, I clearly
  ence points.                                    needed to expand my horizons.
  n Other Japanese investigators allow for a        I resumed my study of Japanese style me-
  wider range of pairings including source and    ridian therapy with its strong emphasis on
  network points.                                 the primary channels with renewed enthu-
                                                  siasm. This immediately brought the pri-
                                                  mary channels back into play in my clinical
  Channel divergence treatment strategies         practice but I was still left with the ques-
based on point pairings combine a “master         tion of how to tie everything together. By
point” on the head with one or more               and large, the senior meridian therapists
points on the extremities. For instance,          I have met have little interest in the chan-
the pairing of LI-4 and LU-9 with ST-12           nel divergences. For better of worse, I have
would be considered a sixth confluence             been left to my own devices in my efforts to
channel divergence treatment exerting             integrate channel divergence and meridian
a deep influence on the Lung and Large             therapies.
Intestine viscera. The precise way in which         Initially I would either do a channel diver-
these points are chosen, combined and             gence treatment or a meridian style treat-
stimulated varies greatly from practitioner.      ment. Over the course of a few years, how-

                                                                                                           The Lantern         17
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  ‘’
                              ever, the two approaches gradually blended        ing in that it is difficult to substantiate in
                              into one another to the extent that they are      truly tangible terms. More importantly, be-
                              now parts of an integrated whole. Current-        cause I need information that will inform
                              ly, although I routinely access the channel       me whether I am being effective during the
The most tangible defining     divergences, this is something that devel-        course of a treatment, I need some more
characteristic of a channel   ops out of the overall flow of the treatment,      immediate feedback mechanisms.
divergence treatment is the   typically as a consequence of my perception         There are two immediate responses that
                              that treating the primary channels alone has      I associate with the activation of the chan-
pairing of points on the
                              been insufficient to produce the effect I am       nel divergences. Neither response is entirely
extremities with associated
                              looking for. This makes sense if we concep-       unique to the channel divergences, and
points on the head and        tualise the channel divergences as digging        both are considered to be indicators of an
shoulder girdle.              a little deeper to get the job done. As I will    overall qi balancing effect. As such, they can
                              discuss, the way in which I have integrated       be achieved in a wide variety of ways. It has
                              these two approaches to acupuncture re-           been my experience, however, that they of-
                              flects some of my fundamental assump-              ten occur together when I have effectively
                              tions regarding what a channel divergence         administered what I define as a channel di-
                              treatment really is.                              vergence treatment and when this happens
                                Returning to my fundamental conun-              I can be more confident of a positive out-
                              drum: how do I know that I’m activating           come from that treatment.
                              a channel divergence? There are no indi-            The first is that the pulse consolidates. By
                              vidual points that are unique to the chan-        this, I mean that the boundaries of the pulse
                              nel divergences. The most tangible defin-          become more defined and coherent. If my
                              ing characteristic of a channel divergence        needling has made the pulse stronger, fuller
                              treatment is the pairing of points on the         and more supple, its boundaries will be-
                              extremities with associated points on the         come better defined, and the qi in the pulse
                              head and shoulder girdle. Yet if we simply        more contained subsequent to needling
                              needle such a pairing how confident can we         the associated points on the head. If the
                              be that we are actually accessing a channel       pulse is hard and wiry to begin with, then
                              divergence as opposed to a couple of points       it softens even as its definition improves.
                              on the primary channels? This is the same         The tendency toward an enhanced healthy
                              dilemma posed by using the so-called mas-         definition of the pulse is consolidation and
                              ter couple point strategies associated with       it must be distinguished from hardness. It
                              the extraordinary vessels.                        is not simply that the pulse becomes more
                                Regardless of how one defines the char-          tense or wiry and therefore its boundaries
                              acteristics of channel divergences or how         are easier to feel. On the contrary, consoli-
                              they should be accessed, if they are indeed       dation typically accompanies an increase
                              different from the primary channels then it       in the suppleness of the pulse. It has been
                              is reasonable to expect that their influence       my experience that the addition of the CD
                              will be somehow distinguishable from the          master points will not necessarily make the
                              primary channels. What might this look            pulse any stronger than a primary channel
                              and feel like? If there were some phenom-         intervention, but in consolidating the qi it
                              ena that one could reliably associate with        gives it some structure or container within
                              the channel divergences, then one would           which to act, thereby enhancing its efficacy.
                              have a reasonable basis for discriminating        This is analogous to the practice of includ-
                              between them and the primary channels.            ing a small astringing component into
                                Enthusiasts of channel divergence treat-        herbal prescriptions for tonifying the yin.
                              ment strategies often claim that these chan-        The improvement in the consolidation
                              nels get to problems that are difficult to         or coherence of the pulse is also accompa-
                              access via the primary channels. This is an       nied by as generalised enhancement in the
                              eminently pragmatic response. It is consis-       overall coherence of the patient’s qi that can
                              tent with my own experience and it satis-         be palpated everywhere on the body. The
                              fies my criterion of efficacy based on early        patient’s qi effectively homogenises.
                              Chinese thinking. Clinically, something is          The homogenisation that I experience of-
                              real if it works. It is nevertheless unsatisfy-   ten seems to radiate down from the head

18         Vol 6–2
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Standard contact needling.                                       Needling BL-1.


and initially it may or may not propagate       nique was sloppy. Sometimes I have simply
along the pathway of the channel I have         jumped the gun and failed to adequately
needled, but the aspect of the phenomena        prepare the patient for work on what is gen-
I am most interested in is its generalised      erally understood to be a deep facet of the
nature. This change is perceptible regard-      channel system. I have not yet really entered
less of where on the patient one places one’s   into a conversation or resonance with the
hand.c                                          patient’s qi. Any of these factors may con-
  Practitioners of meridian therapy often       tribute to an unremarkable response. Effec-
identify pulse consolidation as a positive      tive acupuncture is about doing the right
sign in the progression of treatment so         thing at the right time. We have to take our
it cannot in and of itself be considered a      cues from the qi and our personal agendas
phenomena that is necessarily associated        regarding the progression of treatment are
with the channel divergences. It is a marker    often irrelevant or downright counterpro-
of channel divergence activation only if it     ductive.
is accompanied by a systemic settling and
homogenisation. Both the consolidation          Contact needling
of the pulse and some significant shift to-
ward increased homogenisation must oc-          Many of the master points of the channel
cur for me to be reasonably confident that       divergences are located in the peri-orbital
a channel divergence intervention has been      region, an area where needling can be
worthwhile. To be sure, pulse consolidation     both painful and traumatic for the patient.
and a general settling will often occur with-   Particularly at Jing Ming (BL-1), but also at
in the course of any effective acupuncture      Tong Zi Liao (GB-1), and Cheng Qi (ST-1),
treatment. It is their occurrence together      even the most careful insertion can easily
immediately upon needling the CD points         cause a black eye. Because of this, I prefer
on the head that I believe is significant. The   to stimulate these points using contact
channel divergences are simply a means for      needling only.
deepening a treatment that needs to go to a       Contact needling is a highly evolved
deeper level.                                   technique wherein the needle just barely          Ante Babic’s
  If nothing changes then I interpret this in   touches but does not penetrate the skin.          Tips for running
a number of ways. It may be that a channel      Arguably, it has been most fully developed        a successful clinic ...
divergence treatment was simply irrelevant      within the Toyo Hari style of meridian
                                                                                                  Keep your insurance cur-
to that patient’s needs at that moment, or      therapy.d The effective use of contact nee-
                                                                                                  rent. A patient complained
that I erred in my choice of channel diver-     dling technique requires exceedingly pre-         that the herbs I prescribed
gences. Perhaps the focus of the problem        cise point location to within a fraction of       for him had given his sister
really was in the primary channel and my        a millimetre, and its efficacy is particularly     a rash when she took them.
point selection was poor or my needle tech-     sensitive to the overall posture, level of ten-

                                                                                                       The Lantern          19
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  ‘’
                           sion and mental state of the practitioner.e      to those yin channels in controlling (ke
                           The pressure and the quality of contact of          ) cycle relationship to the channels that
                           the hand of the practitioner that is holding     have been treated. For instance, if one had
                           the needle (the oshide) and the hand that        treated the Kidney and Liver channels, then
I have experimented        is advancing the needle (sashide) are both       one would treat either the Heart or Spleen
extensively with using     essential to the successful execution of the     channels. My criteria for point selection is
CD master points on        technique. Though subtle, when adminis-          based exclusively on which points I find to
                           tered properly, contact needling exerts a po-    be most available based on palpatory find-
the head alone and I am
                           tent influence on the body.                       ings. This may be determined by a variety
unconvinced that such an
                             Once the point has been precisely located      of techniques ranging from firm palpation
approach does much of      and properly contacted by the needle, one        for pressure pain to more subtle assess-
anything at all.           simply waits for the qi to arrive and then       ments such as manual thermal diagnosis
                           rapidly removes the needle, closing the          wherein the practitioner is feeling for ther-
                           point just prior to the point at which the       mal emissions radiating from acupuncture
                           perceived arrival of qi peaks. In the styles     points 10cm off the skin.g I generally use
                           that I am most familiar with, contact nee-       contact needling alone during this phase of
                           dling is generally administered with a #1 or     treatment.
                           #2 silver needle.                                  I have no particular attachment to the
                             Consistent with the principle that the         channel divergences as such; they are sim-
                           yang aspects of the body are relatively more     ply a means to an end. If the stimulation of
                           superficial and the qi more available, it gen-    the primary channels has already produced
                           erally takes only a few seconds for the qi       the result I am looking for then the channel
                           to arrive on the head. Contact needling the      divergences do not even enter my mind. It is
                           CD master points is therefore a relatively       usually after I have finished working the yin
                           rapid procedure.                                 channels and as I’m beginning to work the
                             In contact needling the CD master points       yang channels, when I have yet to observe
                           on the head, it is necessary to take one im-     some essential shift in the patient’s internal
                           portant liberty with the established rules       environment that I engage the channel di-
                           defining the technique. Jing Ming (BL-1) is       vergences.
                           an important point in channel divergence           When I do deem the channel divergences
                           therapy in that it is the access point of both   necessary, I will typically back up a bit and
                           confluence of the Bladder and Kidney, and         needle a single point on the yin facet of the
                           the Heart and Small Intestine confluence.         main channel divergence that I think is im-
                           As such, I use it a great deal. Because it is    paired.
                           impossible to make a proper oshide at BL-1         Depending on the situation, I may use a
                           where both fingers are in full contact with       contact needling technique here or I may
                           the point, I form the oshide using a single      insert the needle. The only criterion I have
                           finger and the orbital surface of the eye.        for the depth of this insertion is that I must
                                                                            have felt the qi arrive in the affected channel.
                           The context of treatment                         As such, it may be an ultra superficial inser-
                                                                            tion that requires tape to keep it in place or
                           My initial choice of which channels to nee-      it may be an insertion of a few millimetres.
                           dle is generally based on the rudimentary        Regardless of its depth, a retained insertion
                           rules outlined in most styles of meridian        on these distal points seems to provide a
                           therapy. Pulse, abdomen, tongue, symptoms        fixed stimulus for their pairing with their
                           and a variety of other palpation techniques      associated CD master points. I have found
                           determine the two most deficient or imbal-        that simply contact needling these distal
                           anced channels. Ideally, these two channels      points again just prior to accessing the mas-
                           are situated next to each other along the        ter points is less effective.
                           generation (sheng ) cycle of a five-phase           I will occasionally couple this yin channel
                           arrangement. For instance, one might treat       point with a point on the associated yang
                           the Pericardium and Spleen, Spleen and           channel divergence on the opposite extrem-
                           Lung, the Lung and Kidney, or the Kidney         ity. Finally, I stimulate their associated CD
                           and Liver channels.f Treatment proceeds          master hole on the head using a contact

20          Vol 6–2
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                                                                                                     ‘’
needling technique. I almost never needle       be the best one can hope for.
yin and yang channels bilaterally on both         It is curious to consider that after over 15
extremities. With this technique I rarely       years of studying, practicing and teaching
find it necessary.                               a wide variety of channel divergence treat-
  I have experimented extensively with us-      ment strategies, my use of this system has         If Chapter 11 of the Ling
ing CD master points on the head alone          been distilled to something as rudimentary         Shu is clear on one thing
and I am unconvinced that such an ap-           as doing a root treatment, stimulating a few
                                                                                                   it is that the channel
proach does much of anything at all. This       points on the head for a few seconds, and
                                                                                                   divergences communicate
leads me to conclude that the pairing of the    then assessing for pulse consolidation and
distal and cephalic points is an essential      qi homogenisation.                                 with qi in the core of the
component of a CD effect. In any case, I am       I will leave it to others to speculate further   body and it is therefore
quite clear I must have established some ba-    on the theoretical implications of the chan-       reasonable to assume that
sic groundwork, entered into some sort of       nel divergences. This admittedly minimalist        they might access and
conversation with the qi, before those head     interpretation nevertheless meets my core          balance deep reserves of qi.
points are of any real use to my patients.      criteria for efficacy and it provides me with
  It would be far more satisfying for me to     a relatively concrete basis for distinguish-
discover palpatory or symptomatic referents     ing between primary and secondary chan-
that are entirely unique to the channel di-     nel influences. Finally, it is an approach that
vergences or the extraordinary vessels, but     allows me to move fluidly between facets of
that does not seem to be the way human          the channel system in response to moment-
bodies are wired. All measures of improve-      to-moment changes in a patient’s qi.
ment are, by their very nature, generalised.
  The bimodal shift that I have described is    Endnotes
merely a benchmark of a progressive deep-       a. For a comprehensive discussion of the
ening in the balance of the qi and it often     channel divergences see Miki Shima and
occurs without my ever having to access the     Charles Chace (2001), Channel Divergences,
CD master points. In this, the question of      Deeper Pathways of the Web. Boulder, Blue
how I know what I am accessing remains          Poppy Press.
open. On the other hand, by the measure         b. Zhang Dong-Sun, cited in David L. Hall
of the how priority attitude described ear-     and Roger T. Ames (1998), Thinking from the
lier and the immediate palpatory feedback       Han: Self Truth and Transcendence in Chinese
I am receiving, it seems that I have indeed     and Western Culture. Albany, State University
accessed the channel divergences or at least    of New York Press: 221.
something that transcends the primary           c. For a further discussion of the palpatory
channels. If Chapter 11 of the Ling Shu is      indicators of balanced qi, see Charles Chace,
clear on one thing it is that the channel di-   “The Shape of Qi,” in The Lantern (2008). Vol
vergences communicate with qi in the core       5-1, pp. 4-11.
                                                d. For an overview of the Toyo Hari style
of the body and it is therefore reasonable to
                                                of meridian therapy see the website: www.
assume that they might access and balance
                                                toyohari.org/
deep reserves of qi.
                                                e. Acupuncture points are, of course, really
  When I administer what I believe to be a      holes or caves (xue ), but when as is the
channel divergence treatment in the proper      case in many styles of meridian therapy, one
circumstances, then my palpatory indica-        attends to point location with this degree of
tors tend to confirm that some deeper level      precision, the focus of attention shifts from
of organisation has indeed occurred. Since I    the hole defining the general anatomical
have already tried and presumably failed to     region to a locus that is indeed much more
produce this effect using primary channel       like a point. For this reason, I have used the
therapies alone, it is reasonable to surmise    word acupuncture point in this essay.
that when I access the channel divergences      f. For a comprehensive discussion of meridian
and something good happens, then I am no        therapy, see Denmai, Shudo (1990) Meridian
longer working on the level of the primary      Therapy. Seattle, Eastland Press.
channels. Given the unimaginably complex        g. For a discussion of this assessment technique
nature of the system we are working with,       see Jean Pierre Barral (1996), Manual Thermal
this very tentative measure of certainty may    Diagnosis. Seattle, Eastland Press.


                                                                                                         The Lantern        21

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The merging ways - by Chip Chace

  • 1. feature The merging of ways An approach to understanding the channel divergences in meridian style therapy By Charles Chace pathways for hyper or hypo tonicity, or per- haps through the sensation of the propaga- tion of qi along a channel when a point on Those who know heaven and know humankind are there. Those its trajectory has been needled. We also have a variety of indirect means of assessing in- who know heaven know heaven gives one life. Whoever knows fluence though changes in the pulse, tongue humankind uses knowing to nurture what cannot be known. and abdomen; but what about the rest of the They will run out the string of their years and not find it cut off channel system? in the middle. This is the fullest knowledge. And yet, though Our influence on those facets of the chan- nel system more closely allied to superficial this is so, there is a problem: knowledge waits on certainty, but anatomical structures such as the channel certainty is never quite certain. sinews (jing jin ) and the network ves- – Zhuangzi Chapter 6: The Great Ancestral Teacher sels (luo mai ) is probably best assessed in two ways, The first is through relatively local changes in the quality of tissues under- lying an effected area that has been directly treated and the second is through some very A CUPUNCTURE is commonly believed to be something of a black box. We in- troduce a stimulus and it has an effect, yet general improvements in the quality of the pulse. By and large, we know that we have had an effect on these channels because we it is often difficult to say why it has worked. literally feel it under our hands. We have a variety of tools that help us navi- The subtlety of these issues increases sig- gate this void, the theoretical structure of the nificantly when it comes to what many con- channel system being the most prominent sider the deepest facets of the channel sys- among them. Many of us have some tangi- tem, the channel divergences (jing bie ) ble experience of the primary channel sys- and the eight extraordinary vessels. Both of tem, perhaps through palpating the channel these channel systems are typically activated 14 Vol 6–2
  • 2. feature ‘’ using pairs of acupuncture points that are what the text said and how it was interpret- located on the primary channels. This poses ed by virtually all the modern sources that an immediate challenge to clearly differenti- I looked at. Subsequent writers had clearly ating the influence of a putative channel di- bridged this gap with a great deal of creative vergence or extraordinary vessel treatment interpretation of their own and this was an One passage in particular, from the more mundane primary channel aspect of the channel system that was cov- a recapitulation of the influence of those two points. The problem ered in virtually all basic textbooks of acu- is particularly germane to the channel diver- puncture. section on the channel gences where the source literature provides At around this time I made the acquain- divergences from Chapter no specific methodology for activating them tance of Miki Shima, a Japanese acupunc- 11 of the Divine Pivot, and there are many different modern ideas turist living in Marin County in California, would haunt me for years. as to how they should be used.a This essay who had made an extensive study of the is an exploration of my attempts to mean- secondary vessels. He generously provided ingfully apply the channel divergences in me with enough insight to turn out a pass- my own clinical practice and to develop a able translation, but how one might actu- model for verifying that I have actually ac- ally use the channel divergences remained a cessed them. mystery to me. In the late 1980s I collaborated with Yang My initial exchange with Miki regarding Shou-Zhong on a translation of Huangfu the channel divergences ultimately led to a Mi’s , Yellow Emperor’s Systematic long and productive friendship, and by the Classic of Acupuncture and Moxibustion mid 1990s we decided to collaborate on a (Huang Di Zhen Jiu Jia Yi Jing book project. Given our mutual interest, the , 3rd century) As the name implies, century). channel divergences were an obvious topic the book is a systematic reorganisation of for us. In this book we reviewed many ap- earlier material from the Ling Shu, Su Wen, proaches to channel divergence therapeutics the Tai Su and a few other now lost texts, culminating in Shima’s own considerable and it constitutes the first real textbook of experience with them. acupuncture practice. Among the most satisfying aspects of that Although I was most decidedly the junior project for me was the opportunity it pro- member of the translation team, the project vided for revisiting Chapter 11 of the Ling was a pivotal point in my development as a Shu. This afforded me a context for once student and practitioner of Chinese medi- again grappling with the issue of how one cine. At that time my work on the Jia Yi Jing makes that pivotal leap from text to prac- provided me with an in-depth exposure to tice. Many of the channel divergences are the contents of the Su Wen and Ling Shu described as traveling along the trajectories and it consolidated my love of pre-modern of their associated primary channels in a medical literature even as it drove home direction but opposite to their usual flow. how challenging texts such as this can be to They therefore present some significant in- meaningfully interpret. Many of its passages terpretive problems. The more I studied the were completely opaque to me and I had no channel system, the closer I came to a con- idea what relevance they might have to my ceptual crisis. There were so many of these own practice of acupuncture. One passage apparent paradoxes that I began to won- in particular, a recapitulation of the section der whether the ancient Chinese actually on the channel divergences from Chapter thought of the channels and networks as 11 of the Divine Pivot, would haunt me for tangible and “real” or were they just handy years. ideas they used when it suited them? n Charles Chace has been a The section on the channel divergences My subsequent readings on early Chinese student of Chinese medicine was the first place in our work on the Jia epistemology and ontology suggested that and its literature for over 25 Yi Jing that truly bothered me. Although the compilers of the Nei Jing had a funda- years. He graduated from the grammar was clear enough, and Profes- mentally different approach to reality than the New England School of sor Yang did his best to explain his under- we do today. Where their contemporary Acupuncture in 1984. He is the standing of the passage to me, I remained Greek counterparts were beginning to ask author and translator of a vari- doubtful that we had any idea what it really the questions concerning the nature of real- ety of books and maintains a meant. Moreover, there was chasm between ity that would define the course of Western clinic in Boulder, Colorado. The Lantern 15
  • 3. feature ‘’ thought for the next two millennia, these regarding the function and influence of the questions were of little interest to the Chi- channel divergences that were so fantastic I nese. During this time in Chinese history, a found them quite literally unbelievable. thing was considered real if it led to effica- Could all these really be different inter- By and large, the senior cious action. They were less concerned with pretations of the same phenomena? In more meridian therapists I have what a thing was than how it could used. pragmatic terms, were these disparate meth- This conceptual distinction has been de- ods all simply various expressions of “how met have little interest in scribed as a “how priority attitude” as op- priority attitude”? There was no question in the channel divergences. posed to a “what priority attitude”b. Such a my mind that Miki, my channel divergence perspective helps to explain how the com- mentor, was satisfied that he was accessing peting and mutually contradictory theories the channel divergences, and I had seen his of yin/yang and the five phases could co- remarkably effective use of strategies that he exist. Each was efficacious in a given set of labelled as channel divergence therapies in circumstances. It also helps to explain how his clinical practice. Similarly, it was clear to qi could be conceptualised as moving in me his teachers Tadashi Irie and Seki truly opposite directions in the same channel. Qi believed they were indeed executing chan- might flow in different ways under different nel divergence treatments. I was even will- circumstances. From that point on I began ing to give some of the European theorists to sift my understanding of the classical the benefit of the doubt that they too were medical literature through the filter of what indeed accessing the channel divergences I imagined a how priority attitude might be, even though I believed that many of their but I had not focused this perspective on a fundamental premises were based on a tex- critical examination of my own practice. tual misinterpretation. Around the time our channel divergence In my own practice, some of these ap- book went to press, I had lunch with Jeffrey proaches most definitely worked better for Dann, a friend and colleague with whom I me than others and many failed my per- share an interest in palpation based styles sonal test of efficacy. Clearly, no one else’s of acupuncture, particularly those from Ja- firmly held conviction would ever be suf- pan. He quite innocently asked me if I re- ficient to dispel my own uncertainty, and ally thought that the channel divergences it was up to me to define my own criteria were an effective means of treatment. My for what constitutes a channel divergence knee-jerk response was an unqualified and treatment. When does any acupuncture effusive endorsement of the channel diver- intervention become a channel divergence gence strategies. True, I did have a vested treatment and how do I know that I have interest in that answer. I had spent the pre- been effective? vious four years researching the channel The following discussion assumes a cer- divergences and I had a book coming out tain familiarity on the part of the reader on the topic. Of course I was sure that they with both the essentials of meridian style worked! Jeffrey nodded politely the way therapy and with some of the fundamen- one does when one discovers one has unin- tal concepts associated with the channel tentionally trod on delicate ground and our divergences. Those interested in a compre- conversation turned to other things … but hensive discussion of meridian therapy will he had planted an insidious seed. find Shudo Denmei’s excellent Japanese At that point I had been exposed to a wide Classical Acupuncture, Introduction to Me- range of perspectives on channel divergence ridian Therapy (1990) informative. Those treatment from both Asia and Europe, each interested in a more thorough introduction of which was based on differing assump- to channel divergence therapeutics will find tions regarding nature and topology of the Channel Divergences, Deeper Pathways of channel divergences. Some of these strate- the Web by Miki Shima and Charles Chace gies were Byzantine in their complexity, (2001) of interest. while others were remarkably simple. Al- For the purposes of this essay, however, though the Japanese sources limited their some of the key ideas concerning channel scope of interest to relatively tangible and divergence therapy are summarised in the practical applications, others made claims following tables. 16 Vol 6–2
  • 4. feature Central characteristics of A basic channel divergence treatment model the channel divergences Channel Master point Source Network Uniting LU ST-12 LI-4 LI-6 LI-11 n The channel divergences are the primary LI ST-12 LU-9 LU-7 LU-5 and deepest internal pathways of the chan- P GB-12 P-7 P-6 P-3 nel system. SJ GB-12 SJ-4 SJ-5 SJ-10 n The channel divergences are arranged in HE BL-1 HE-7 HE-5 HE-3 yin-yang pairs referred to as confluences SI BL-1 SI-4 SI-7 SI-8 ( he). SP ST-1 SP-3 SP-4 SP-9 n The channel divergences directly link the ST ST-1 ST-42 ST-40 ST-36 core with the exterior and exterior with the LIV GB-1 LIV-3 LIV-5 LIV-8 core. GB GB-1 GB-40 GB-37 GB-34 n All channel divergences move upward and BL-11 ultimately outward in the body. KID KID-3 KID-4 KID-10 BL-1 n All channel divergences terminate in the BL-11 face/neck. BL BL-64 BL-65 BL-40 BL-1 n All confluences directly or indirectly pass through the heart/chest. The above table summarises some of n Channel divergences provide a direct con- the most common choices for channel nection between the yuan, ying and wei qi. divergence pairings. n European sources emphasise wei qi/net- This pairing of distal points on the ex- work vessel relationships. tremities with an associated master point n Japanese sources emphasise ying qi–yuan on the head is the basis for all channel di- qi/zang fu relationships. vergence strategies that I have found to be effective. As such, it is my criteria for defining chan- nel divergence activation. Fundamental treatment After six or seven years of actively ori- premises enting my acupuncture practice around n Most channel divergence treatment strate- combinations of channel divergence and gies require two points, a “master” and a extraordinary vessel treatment strategies, I “couple”, to activate them. realised that I had been consistently over- n The master points are located on the head looking the primary channels. Since my ul- and neck. timate goal was to maximise my use of the n Shima’s interpretation is that these cepha- entire channel system of which the chan- lad points must be paired with the he conflu- nel divergences are only one part, I clearly ence points. needed to expand my horizons. n Other Japanese investigators allow for a I resumed my study of Japanese style me- wider range of pairings including source and ridian therapy with its strong emphasis on network points. the primary channels with renewed enthu- siasm. This immediately brought the pri- mary channels back into play in my clinical Channel divergence treatment strategies practice but I was still left with the ques- based on point pairings combine a “master tion of how to tie everything together. By point” on the head with one or more and large, the senior meridian therapists points on the extremities. For instance, I have met have little interest in the chan- the pairing of LI-4 and LU-9 with ST-12 nel divergences. For better of worse, I have would be considered a sixth confluence been left to my own devices in my efforts to channel divergence treatment exerting integrate channel divergence and meridian a deep influence on the Lung and Large therapies. Intestine viscera. The precise way in which Initially I would either do a channel diver- these points are chosen, combined and gence treatment or a meridian style treat- stimulated varies greatly from practitioner. ment. Over the course of a few years, how- The Lantern 17
  • 5. feature ‘’ ever, the two approaches gradually blended ing in that it is difficult to substantiate in into one another to the extent that they are truly tangible terms. More importantly, be- now parts of an integrated whole. Current- cause I need information that will inform ly, although I routinely access the channel me whether I am being effective during the The most tangible defining divergences, this is something that devel- course of a treatment, I need some more characteristic of a channel ops out of the overall flow of the treatment, immediate feedback mechanisms. divergence treatment is the typically as a consequence of my perception There are two immediate responses that that treating the primary channels alone has I associate with the activation of the chan- pairing of points on the been insufficient to produce the effect I am nel divergences. Neither response is entirely extremities with associated looking for. This makes sense if we concep- unique to the channel divergences, and points on the head and tualise the channel divergences as digging both are considered to be indicators of an shoulder girdle. a little deeper to get the job done. As I will overall qi balancing effect. As such, they can discuss, the way in which I have integrated be achieved in a wide variety of ways. It has these two approaches to acupuncture re- been my experience, however, that they of- flects some of my fundamental assump- ten occur together when I have effectively tions regarding what a channel divergence administered what I define as a channel di- treatment really is. vergence treatment and when this happens Returning to my fundamental conun- I can be more confident of a positive out- drum: how do I know that I’m activating come from that treatment. a channel divergence? There are no indi- The first is that the pulse consolidates. By vidual points that are unique to the chan- this, I mean that the boundaries of the pulse nel divergences. The most tangible defin- become more defined and coherent. If my ing characteristic of a channel divergence needling has made the pulse stronger, fuller treatment is the pairing of points on the and more supple, its boundaries will be- extremities with associated points on the come better defined, and the qi in the pulse head and shoulder girdle. Yet if we simply more contained subsequent to needling needle such a pairing how confident can we the associated points on the head. If the be that we are actually accessing a channel pulse is hard and wiry to begin with, then divergence as opposed to a couple of points it softens even as its definition improves. on the primary channels? This is the same The tendency toward an enhanced healthy dilemma posed by using the so-called mas- definition of the pulse is consolidation and ter couple point strategies associated with it must be distinguished from hardness. It the extraordinary vessels. is not simply that the pulse becomes more Regardless of how one defines the char- tense or wiry and therefore its boundaries acteristics of channel divergences or how are easier to feel. On the contrary, consoli- they should be accessed, if they are indeed dation typically accompanies an increase different from the primary channels then it in the suppleness of the pulse. It has been is reasonable to expect that their influence my experience that the addition of the CD will be somehow distinguishable from the master points will not necessarily make the primary channels. What might this look pulse any stronger than a primary channel and feel like? If there were some phenom- intervention, but in consolidating the qi it ena that one could reliably associate with gives it some structure or container within the channel divergences, then one would which to act, thereby enhancing its efficacy. have a reasonable basis for discriminating This is analogous to the practice of includ- between them and the primary channels. ing a small astringing component into Enthusiasts of channel divergence treat- herbal prescriptions for tonifying the yin. ment strategies often claim that these chan- The improvement in the consolidation nels get to problems that are difficult to or coherence of the pulse is also accompa- access via the primary channels. This is an nied by as generalised enhancement in the eminently pragmatic response. It is consis- overall coherence of the patient’s qi that can tent with my own experience and it satis- be palpated everywhere on the body. The fies my criterion of efficacy based on early patient’s qi effectively homogenises. Chinese thinking. Clinically, something is The homogenisation that I experience of- real if it works. It is nevertheless unsatisfy- ten seems to radiate down from the head 18 Vol 6–2
  • 6. feature Standard contact needling. Needling BL-1. and initially it may or may not propagate nique was sloppy. Sometimes I have simply along the pathway of the channel I have jumped the gun and failed to adequately needled, but the aspect of the phenomena prepare the patient for work on what is gen- I am most interested in is its generalised erally understood to be a deep facet of the nature. This change is perceptible regard- channel system. I have not yet really entered less of where on the patient one places one’s into a conversation or resonance with the hand.c patient’s qi. Any of these factors may con- Practitioners of meridian therapy often tribute to an unremarkable response. Effec- identify pulse consolidation as a positive tive acupuncture is about doing the right sign in the progression of treatment so thing at the right time. We have to take our it cannot in and of itself be considered a cues from the qi and our personal agendas phenomena that is necessarily associated regarding the progression of treatment are with the channel divergences. It is a marker often irrelevant or downright counterpro- of channel divergence activation only if it ductive. is accompanied by a systemic settling and homogenisation. Both the consolidation Contact needling of the pulse and some significant shift to- ward increased homogenisation must oc- Many of the master points of the channel cur for me to be reasonably confident that divergences are located in the peri-orbital a channel divergence intervention has been region, an area where needling can be worthwhile. To be sure, pulse consolidation both painful and traumatic for the patient. and a general settling will often occur with- Particularly at Jing Ming (BL-1), but also at in the course of any effective acupuncture Tong Zi Liao (GB-1), and Cheng Qi (ST-1), treatment. It is their occurrence together even the most careful insertion can easily immediately upon needling the CD points cause a black eye. Because of this, I prefer on the head that I believe is significant. The to stimulate these points using contact channel divergences are simply a means for needling only. deepening a treatment that needs to go to a Contact needling is a highly evolved deeper level. technique wherein the needle just barely Ante Babic’s If nothing changes then I interpret this in touches but does not penetrate the skin. Tips for running a number of ways. It may be that a channel Arguably, it has been most fully developed a successful clinic ... divergence treatment was simply irrelevant within the Toyo Hari style of meridian Keep your insurance cur- to that patient’s needs at that moment, or therapy.d The effective use of contact nee- rent. A patient complained that I erred in my choice of channel diver- dling technique requires exceedingly pre- that the herbs I prescribed gences. Perhaps the focus of the problem cise point location to within a fraction of for him had given his sister really was in the primary channel and my a millimetre, and its efficacy is particularly a rash when she took them. point selection was poor or my needle tech- sensitive to the overall posture, level of ten- The Lantern 19
  • 7. feature ‘’ sion and mental state of the practitioner.e to those yin channels in controlling (ke The pressure and the quality of contact of ) cycle relationship to the channels that the hand of the practitioner that is holding have been treated. For instance, if one had the needle (the oshide) and the hand that treated the Kidney and Liver channels, then I have experimented is advancing the needle (sashide) are both one would treat either the Heart or Spleen extensively with using essential to the successful execution of the channels. My criteria for point selection is CD master points on technique. Though subtle, when adminis- based exclusively on which points I find to tered properly, contact needling exerts a po- be most available based on palpatory find- the head alone and I am tent influence on the body. ings. This may be determined by a variety unconvinced that such an Once the point has been precisely located of techniques ranging from firm palpation approach does much of and properly contacted by the needle, one for pressure pain to more subtle assess- anything at all. simply waits for the qi to arrive and then ments such as manual thermal diagnosis rapidly removes the needle, closing the wherein the practitioner is feeling for ther- point just prior to the point at which the mal emissions radiating from acupuncture perceived arrival of qi peaks. In the styles points 10cm off the skin.g I generally use that I am most familiar with, contact nee- contact needling alone during this phase of dling is generally administered with a #1 or treatment. #2 silver needle. I have no particular attachment to the Consistent with the principle that the channel divergences as such; they are sim- yang aspects of the body are relatively more ply a means to an end. If the stimulation of superficial and the qi more available, it gen- the primary channels has already produced erally takes only a few seconds for the qi the result I am looking for then the channel to arrive on the head. Contact needling the divergences do not even enter my mind. It is CD master points is therefore a relatively usually after I have finished working the yin rapid procedure. channels and as I’m beginning to work the In contact needling the CD master points yang channels, when I have yet to observe on the head, it is necessary to take one im- some essential shift in the patient’s internal portant liberty with the established rules environment that I engage the channel di- defining the technique. Jing Ming (BL-1) is vergences. an important point in channel divergence When I do deem the channel divergences therapy in that it is the access point of both necessary, I will typically back up a bit and confluence of the Bladder and Kidney, and needle a single point on the yin facet of the the Heart and Small Intestine confluence. main channel divergence that I think is im- As such, I use it a great deal. Because it is paired. impossible to make a proper oshide at BL-1 Depending on the situation, I may use a where both fingers are in full contact with contact needling technique here or I may the point, I form the oshide using a single insert the needle. The only criterion I have finger and the orbital surface of the eye. for the depth of this insertion is that I must have felt the qi arrive in the affected channel. The context of treatment As such, it may be an ultra superficial inser- tion that requires tape to keep it in place or My initial choice of which channels to nee- it may be an insertion of a few millimetres. dle is generally based on the rudimentary Regardless of its depth, a retained insertion rules outlined in most styles of meridian on these distal points seems to provide a therapy. Pulse, abdomen, tongue, symptoms fixed stimulus for their pairing with their and a variety of other palpation techniques associated CD master points. I have found determine the two most deficient or imbal- that simply contact needling these distal anced channels. Ideally, these two channels points again just prior to accessing the mas- are situated next to each other along the ter points is less effective. generation (sheng ) cycle of a five-phase I will occasionally couple this yin channel arrangement. For instance, one might treat point with a point on the associated yang the Pericardium and Spleen, Spleen and channel divergence on the opposite extrem- Lung, the Lung and Kidney, or the Kidney ity. Finally, I stimulate their associated CD and Liver channels.f Treatment proceeds master hole on the head using a contact 20 Vol 6–2
  • 8. feature ‘’ needling technique. I almost never needle be the best one can hope for. yin and yang channels bilaterally on both It is curious to consider that after over 15 extremities. With this technique I rarely years of studying, practicing and teaching find it necessary. a wide variety of channel divergence treat- I have experimented extensively with us- ment strategies, my use of this system has If Chapter 11 of the Ling ing CD master points on the head alone been distilled to something as rudimentary Shu is clear on one thing and I am unconvinced that such an ap- as doing a root treatment, stimulating a few it is that the channel proach does much of anything at all. This points on the head for a few seconds, and divergences communicate leads me to conclude that the pairing of the then assessing for pulse consolidation and distal and cephalic points is an essential qi homogenisation. with qi in the core of the component of a CD effect. In any case, I am I will leave it to others to speculate further body and it is therefore quite clear I must have established some ba- on the theoretical implications of the chan- reasonable to assume that sic groundwork, entered into some sort of nel divergences. This admittedly minimalist they might access and conversation with the qi, before those head interpretation nevertheless meets my core balance deep reserves of qi. points are of any real use to my patients. criteria for efficacy and it provides me with It would be far more satisfying for me to a relatively concrete basis for distinguish- discover palpatory or symptomatic referents ing between primary and secondary chan- that are entirely unique to the channel di- nel influences. Finally, it is an approach that vergences or the extraordinary vessels, but allows me to move fluidly between facets of that does not seem to be the way human the channel system in response to moment- bodies are wired. All measures of improve- to-moment changes in a patient’s qi. ment are, by their very nature, generalised. The bimodal shift that I have described is Endnotes merely a benchmark of a progressive deep- a. For a comprehensive discussion of the ening in the balance of the qi and it often channel divergences see Miki Shima and occurs without my ever having to access the Charles Chace (2001), Channel Divergences, CD master points. In this, the question of Deeper Pathways of the Web. Boulder, Blue how I know what I am accessing remains Poppy Press. open. On the other hand, by the measure b. Zhang Dong-Sun, cited in David L. Hall of the how priority attitude described ear- and Roger T. Ames (1998), Thinking from the lier and the immediate palpatory feedback Han: Self Truth and Transcendence in Chinese I am receiving, it seems that I have indeed and Western Culture. Albany, State University accessed the channel divergences or at least of New York Press: 221. something that transcends the primary c. For a further discussion of the palpatory channels. If Chapter 11 of the Ling Shu is indicators of balanced qi, see Charles Chace, clear on one thing it is that the channel di- “The Shape of Qi,” in The Lantern (2008). Vol vergences communicate with qi in the core 5-1, pp. 4-11. d. For an overview of the Toyo Hari style of the body and it is therefore reasonable to of meridian therapy see the website: www. assume that they might access and balance toyohari.org/ deep reserves of qi. e. Acupuncture points are, of course, really When I administer what I believe to be a holes or caves (xue ), but when as is the channel divergence treatment in the proper case in many styles of meridian therapy, one circumstances, then my palpatory indica- attends to point location with this degree of tors tend to confirm that some deeper level precision, the focus of attention shifts from of organisation has indeed occurred. Since I the hole defining the general anatomical have already tried and presumably failed to region to a locus that is indeed much more produce this effect using primary channel like a point. For this reason, I have used the therapies alone, it is reasonable to surmise word acupuncture point in this essay. that when I access the channel divergences f. For a comprehensive discussion of meridian and something good happens, then I am no therapy, see Denmai, Shudo (1990) Meridian longer working on the level of the primary Therapy. Seattle, Eastland Press. channels. Given the unimaginably complex g. For a discussion of this assessment technique nature of the system we are working with, see Jean Pierre Barral (1996), Manual Thermal this very tentative measure of certainty may Diagnosis. Seattle, Eastland Press. The Lantern 21