Books

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.

Understanding Acupuncture Through Children's Books

Whether you're shopping for a child or looking for a good way into the world of acupuncture yourself, these children's books are worth checking out. Here are my takes on each of the children's books on acupuncture I've encountered so far:

 For more info, visit www.acupuncturekidsbook.com

For more info, visit www.acupuncturekidsbook.com

Maya and Friends Visit the Acupuncturist

By Samara White, L.Ac. and illustrated by Troy White

Children's books have to streamline concepts and so are often unexpectedly helpful in explaining complicated ideas simply and clearly. This book has been a big hit in my waiting rooms and at health fairs. In it, a little girl named Maya wakes up with sniffles and sneezes, then listens to the advice of her friends, Ellie the Elephant and Bobby Bear, and goes with them to visit Dr. Meow. I love elephants so Ellie totally won me over (so cute when she gets cupping!). Dr. Meow also sends a very important message for children (and adults!) when she makes it very clear that nothing happens to your body without your consent. And how can you resist a teddy bear marveling at meridians?

This book offers simple explanations for qi, yin, yang, and herbs and moxa in addition to expectations for the patient experience. And it rhymes so you might find yourself recalling lines here and there.

Pro: The best overall explanation of acupuncture and Chinese medicine, fun to read out loud

Con: Some of the illustrations are a little uncanny

Verdict: If you only get one book, this one's my favorite overall.

My Visit to the Acupuncturist

By Stacey V. Leung and illustrated by Daniel Griffo

This bold and colorful book is so sweet! It focuses on how acupuncture can help kids (and, by extension, any patient) get back to their favorite activities and how sessions work so you don't have to be scared. A little boy injures his ankle playing soccer and just wants to get back to playing ball. He finds that acupuncture isn't scary and it helps him heal over a series of sessions.

"My Visit" is a nice complement to "Maya and Friends" that focuses on the patient experience and in general has nicer illustrations. A big bonus is seeing acupuncture in an integrative context: the doctor who examines the boy's X-ray is the one to tell him Jane (the acupuncturist) will help with "the swelling and pain" and her office is right next door to physical therapy (just like mine!).

Pro: Uncomplicated, a simple introduction to the patient experience of acupuncture, illustrates integrative care

Con: Doesn't talk about how acupuncture works

Verdict: If you (or your little one) are nervous about going to acupuncture, this one is probably the best for allaying fears. Also great focus on sports medicine. 

The Five: A Journey to Find a Home

By Dr. Coleen Smith and illustrated by Alaina Schreiner 

This colored pencil style volume is billed as a children's book, but instead I would recommend it for anyone beginning acupuncture school. I never got into Zoo Cards (a set of flashcards for learning Chinese herbs), but this feels like a similar tool. The book illustrates the five elements and their characteristics in a way that feels less like a story and more like an elaborate mnemonic device.

For example the story has Livgall the green-eyed monkey, Luli the white bird, Kibla the blue fish, Splesto the yellow lion, and Hearsi the red dragon search for the perfect environment to call home. Character names are not smoothed into something a character might be called but just direct combinations of the channel pairs (Livgall is Liver and Gall Bladder, Luli is Lung and Large Intestine, etc). The adjectives that describe the characters and their chosen environments align with the five element sounds, smells, cardinal directions, etc.

I could imagine finding this book useful in the beginning of school when there is so much information to take in and anything sweet and colorful is a helpful respite! Maybe even as a little treat when studying for California Licensing and National Board exams.

Pro: Detailed five element overview equals good study tool (there's even a chart in the back)

Con: More educational than enjoyable

Verdict: Great for first year acupuncture students or for board exam study! Probably not a kid favorite.

Have I missed any acupuncture children's books that you know and love? I love book recommendations so send me your suggestions!

ABOUT SHAWNA

Shawna Seth, L.Ac., Dipl. Ac. is a California-licensed and nationally-certified acupuncturist whose areas of specialty include promoting women’s health and fertility and breaking the cycles of stress, anxiety, and depression. She uses the gentlest effective methods possible to guide her patients to balance. Shawna sees patients both in her private practice in San Francisco and in a collaborative practice in Temescal, Oakland. To learn more about Japanese medicine and the world of acupuncture, read her blog A Cuppa Qi and make your appointments online or email contact@shawnaseth.com.

Header image: illustration by Troy White from "Maya and Friends Visit the Acupuncturist"

Acupuncturist's Oath

Someone asked me recently if acupuncturists take the Hippocratic Oath like Western Medical doctors do. Many things Hippocrates wrote show how much the roots of Western medicine resemble traditional medicine. For instance, "It is far more important to know what person the disease has than what disease the person has."

But instead of taking the Hippocratic oath, at our graduation from the Acupuncture & Integrative Medicine College with our Masters of Science in Oriental Medicine (MSOM), we took Sun Si Miao's Oath of the Great Physician.

The Acupuncturists' Oath reads:

I promise to follow the way of the Great Physician, to live in harmony with nature, and to teach my patients to do the same.
I will strive to maintain a clear mind and hold myself to the highest standards.
I shall look upon those who are in grief as though I myself have been afflicted, and I will respond with empathy.
I shall develop an attitude of compassion, of benevolence, and of care for all patients, regardless of their particular circumstances.
I promise to perform my responsibilities carefully, thoughtfully, and to the best of my ability.
Above all, I will maintain a peaceful presence and an open heart.
Based on the Oath of Sun Si Miao (c. 581-682), whose code is considered to be the foundation of Chinese medical ethics.

Photo of Shawna at the new Tianjin Hospital in China in front of Sun Si Miao's Oath

For comparison's sake, here is the modern Hippocratic Oath, written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used by many medical schools today. (source)

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

ABOUT SHAWNA

Shawna Seth, L.Ac., Dipl. Ac. is a California-licensed and nationally-certified acupuncturist whose areas of specialty include promoting women’s health and fertility and breaking the cycles of stress, anxiety, and depression. She uses the gentlest effective methods possible to guide her patients to balance. Shawna sees patients both in her private practice in San Francisco and in a collaborative practice in Temescal, Oakland. To learn more about Japanese medicine and the world of acupuncture, read her blog A Cuppa Qi and make your appointments online or email contact@shawnaseth.com.

Photo: Unsplash

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, I would be happy to bring this book into either my San Francisco or Albany clinic so 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-licensed and nationally-certified acupuncturist whose areas of specialty include promoting women’s health and fertility and breaking the cycles of stress, anxiety, and depression. She uses the gentlest effective methods possible to guide her patients to balance. Shawna sees patients both in her private practice in San Francisco and in a collaborative practice in Temescal, Oakland. To learn more about Japanese medicine and the world of acupuncture, read her blog A Cuppa Qi and make your appointments online or email contact@shawnaseth.com.

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