TCM

Japanese Meridian Therapy and Traditional Chinese Medicine: A Classical and Clinical Comparison

Japanese Meridian Therapy and Traditional Chinese Medicine: A Classical and Clinical Comparison

A Note From Shawna

This paper was originally titled, "Classic Texts: The Foundation of Japanese Meridian Therapy Assessed Clinically in Comparison to Traditional Chinese Medicine." I wrote it during the final years of my masters program in acupuncture at AIMC Berkeley for a course on classical texts.

This paper presumes knowledge of the medicine so is most appropriate for other practitioners, but as patients often ask about Japanese vs Chinese medicine, a general audience might find it interesting to skim. I'm happy to discuss any questions you may have after reading.

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How can Japanese Meridian Therapy and Traditional Chinese Medicine have come from the same classic texts and yet come to such different conclusions for diagnosis and treatment? This is the question I chose to consider by delving into Chapters Sixty-Nine and Seventy-Five of the Nan Jing, considered the foundation of Japanese Meridian Therapy.

Meridian Therapy was founded in the 1930s out of a desire to “reexamine the classics and to clinically test the knowledge gained therein in order to extract the truth” (Kuwahara, xvii). The principle methods of Japanese Meridian Therapy (JMT or MT) are to palpate and assess the meridians, using the pulse for both diagnosis and continual assessment of the progress of treatment, and to use the meridians in this way to understand the balance of deficiency and excess caused by pathogens, the seven emotions, and the fundamental interaction of the meridians and organs to themselves and each other (the Five Phases). This is fairly different from Eight Principle and Zang Fu Diagnosis as interpreted in Traditional Chinese Medicine (TCM). In the TCM approach, we utilize the four diagnostic methods (asking, looking, listening, and palpating), base our diagnosis on the collection of symptoms and signs based on the chief complaint, and identify a specific pattern based on the organs, yin/yang, and body elements (like blood, body fluids, and qi) in disharmony, all of which determines the course of treatment. Depending on the TCM practitioner, palpation may be used to refine the choice of points (this is common at least in the case of choosing local ashi points) or at the extreme they may only use the trusted points in texts from Chinese Acupuncture and Moxibustion (CAM). I admit this is a gross simplification of the vast differences within the practices of TCM and JMT respectively, but seeing from the extremes can help to highlight the differences between the disciplines.

Inspiration from the Past

Over the past few months I've been taking time to read a brilliant little book called Miscellaneous Records of a Female Doctor. It's a new (published 2015) translation of a discovery from the rare book library of the Beijing Institute of Traditional Chinese Medicine, an account of 31 cases by the Ming Dynasty practitioner Tán Yǔnxián. That's a female doctor from 1500s China! I heard about the book while listening to an episode of the Yin Yang podcast with guest Lorraine Wilcox, who was speaking about moxibustion (Episode #34 Why Moxa?). Moxibustion, also known as moxa, is a particular love of mine so I leapt to hear this topic as a treat. Turns out that in addition to her fascinating study of moxa, Wilcox translated this Ming Dynasty book. Who knows how many other female doctors there were at the time or how many wrote books, but I'm glad this one survived. It's exciting to read as I operate in the modern world of our profession.

Cases during the Ming were not only filtered through the male doctor’s understanding, but the reported symptoms were filtered through the husband’s words.

Tán's patients were all female, ranging in age from six to sixty-nine. During the Ming Dynasty, women had to have a male relative present when seeing a male doctor so part of what set her apart was surely her ability to speak with a patient one on one and not to have the male explain her symptoms for her!

"Therefore, cases during the Ming were not only filtered through the male doctor's understanding, but the reported symptoms were filtered through the husband's words. If the wife was angry because the husband wanted a concubine, would the husband have said so? Even if he did, he and the male doctor would think it perfectly within his rights. This is perhaps why women were perceived as angry by nature in most accounts, not due to circumstances of their lives.

"In addition, to sit quietly by while one's own intimate bodily functions are discussed by two males must have been an embarrassing experience. Is it any wonder then that women preferred to see a female healthcare practitioner when they could?" (24)

These were women who held power that males could not easily restrict.

Part of what makes her cases so fascinating is that, unlike male practitioners' case study books of similar periods, she does explain the life circumstances that relate to the patient's affliction. Anger and vomiting blood. Shame and a red rash. Since both Chinese and Japanese medicine hold that the emotions affect the health of the body, it is more surprising to me that the male practitioners were not fully taking into account the patient's emotional state.

"Another reason female health care practitioners were not trusted by men is that they had access to the women's inner quarters, an area generally forbidden to males. [...] They had full access to questioning, pulse, and facial diagnosis. They also could be consulted about abortion, birth control, and so forth. The husband might want control of these, but a female practitioner could circumvent him. These were women who held power that males could not easily restrict." (25)

How far we've come and how lucky we are! We have not only the freedom to seek treatment on our own, but access to this medicine that has such gentle yet effective power. Just as Tán treated women for menstrual disorders and postpartum care as well as numbness of the hands and muscle atrophy, acupuncture is a medical system that considers the entire body and mind.

I would not say that this would be a page-turner for those who are not acupuncturists or possibly Chinese history scholars as the majority of the book is made up of specific case details (especially versions of herbal formulas and analyses of these). However, you can flip through it before or after a treatment. The introductory chapters (excerpted above) are illuminating.

ABOUT SHAWNA

Shawna Seth, L.Ac., Dipl. Ac. is a California state licensed and nationally certified acupuncturist focused on promoting women’s health, especially surrounding menstrual health and fertility. She uses the gentlest effective methods possible to guide her patients to balance. Shawna sees patients in her private practice on Sutter Street in San Francisco. Make your appointments online or email contact@shawnaseth.com. To learn more about Japanese medicine and the world of acupuncture, follow her blog A Cuppa Qi.

Image credit: Cover of Miscellaneous Records of a Female Doctor by Tán Yǔnxián translated by Lorraine Wilcox with Yue Lu