16
Huang Di Nei Jing Ling Shu: The Ancient Classic on Needle Therapy
Journal of Chinese Medicine • Number 111 • June 2016
In its entirety the text gives the impression that the authors strived to make all health problems that confronted the people of the time comprehensible within their secular explanatory model based purely on natural laws. Only the comprehension, we read, makes successful treatment possible.
9. Therapy
Starting therapy without a thorough diagnosis is rejected and attributed only to “unrefined” practitioners. Therapeutic procedures to be used for treating a patient are multiple and can hardly be grasped competently by one healer alone. The authors of the Ling shu knew that a medical treatment could not be some kind of mechanistic repair. Chapter 29 of the Ling shu therefore spells out how important it is to find out what patients want and what would help them. The author uses comparisons to make the point.
“One enters a [foreign] country, and enquires about
its customs. One enters [someone else’s] household, and enquires about their taboos. One enters [someone’s ancestral] hall and enquires about the rites to be observed. One attends to a patient and enquires about what will ease his condition.”
We can read between the lines that the patient’s mental expectations and emotional needs greatly influence the therapy’s success. Therefore, treatment must incorporate the patient’s social environment into the therapy instead of regarding the illness in isolation. High-ranking individuals are both approached differently in their diagnosis and receive a special, perhaps less aggressive therapy. Where the average patient would be treated with “fire,” i.e. cauterization, loftier clientele are given gentle compresses to bring the required warmth into the body. This differentiated approach is discussed especially clearly in chapter 5 of the Ling shu:
Huang Di: “Now, kings, dukes, and eminent persons, gentlemen who consume bloody [meat], their body is soft and fragile, and their muscles and flesh are gentle and weak. [The flow of] their blood and qi is swift and vigorous, smooth and unimpeded. Is it at all possible that when piercing them, whether an insertion is slow or fast, shallow or deep, often times or few times, could be identical with [the treatment of normal persons]?”
Qi Bo answered: “How could rich food and coarse vegetables be identical?! If the [flow of] qi is smooth, [the needle] is to be removed quickly. If the [flow of] qi is rough, [the needle] is to be removed slowly. If the [flow of] qi is vigorous, then the needle must be small and it is to be inserted superficially. If the [flow of] qi is rough, then the needle must be big and it is to be inserted deeply. [A needle] in the depth is to remain there. [A needle] at the surface is [to be removed] quickly.
Looking at it this way, when piercing normal persons [the needle is to be inserted] into the depth, and is to remain there. When piercing eminent persons, [the needle is to enter the skin] only a little, and is to be withdrawn quickly. This is so because it is always such that the [flow of the] qi [of the latter] is swift and vigorous, smooth and unimpeded.”
The procedures ultimately executed by the expert use acupuncture first and foremost. Needles might be as fine and supple as a hair and penetrate into the organism to a greater or lesser degree. The Ling shu includes a list of the nine varieties of needles right in the first chapter. They might be heated and inserted directly on the painful area, for example when used on strained sinews accompanied by severe pain, fast breathing and spitting blood. They might also be needles with a ball-shaped end, so that they clear a path by pushing structures aside without doing damage when they are inserted. They might also be sharp blades used with the opposite intention, namely of opening the skin to drain pus or open the vessels to let blood. The “removal,” qu 取, of blood is a therapy connected to the ontic view of the illness, one that is often recommended in the Ling shu. The illness is removed along with the blood, according to the text. There may have already been skeptics in antiquity whether these little needles were really as important as the new medicine claimed. A question to this effect is asked by Huang Di, and Qi Bo makes some emphatic comparisons to confirm the needles’ significance. The most important position in nature is occupied by man. Weapons are used to kill him in war. To save his life, medicine uses the little needles:
Huang Di: “For me the small needles are insignificant items. Now you say that above they are united with heaven, below they are united with the earth, and in the middle they are united with mankind. To me this seems to greatly exaggerate their significance! I wish to be informed of the underlying reason.”
Qi Bo: “Is there anything bigger than heaven? Now, what is bigger than the needles? Only the five weapons. The five weapons are prepared to kill. They are not employed to keep [someone] alive. Furthermore now, mankind! The most precious item between heaven and earth. How could it be neglected? Now, to cure the [diseases] of humans, only the needles are to be applied. Now, when the needles are compared with the five weapons, which turns out to be less significant?”
The common therapeutic approach in the Ling shu describes a health problem and then recommends acupuncture or bloodletting from a particular vessel or at a defined part
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14