A State of Profound Understanding

On Acupuncture and Herbal Medicine Correspondences

different paths lead to the same mountain, image made with Dream A.I.

I’ve spent quite a bit of time over the last few years looking at the actions of Chinese herbal materia medica and formulas and trying to work out how their treatment principles might correspond with acupuncture in a more comprehensive way than what we usually see in most modern books. You can see some examples of that here, here, and here.

Most of the books I have been looking at are from the late Imperial periods (Míng and especially the Qīng). The literature is heavily weighted toward internal (i.e. herbal) medicine, and there are few acupuncture classics for which we don’t by now have excellent translations. Every so often I come across an unfamiliar work on acupuncture and find it contains something really thought provoking and useful. In those cases, I usually try to scrape together a working version in English and put it out on the mulch pile.

I’ve recently been looking through Zhēn Fāng Liù Jí [針方六集, Six Collections of Acupuncture Prescriptions] by Wú Kūn, written in the Míng era, 1618. I previously cited his formula book here. Aside from being a comprehensive acupuncture text with all of the things you would expect in such a book, there is a section in the middle that caught my eye when I was scanning the headers. It is a series of short essays on acupuncture and herbal medicine. The first essay is as follows:

針藥無二致一

藥有汗、有吐、有下、有溫、有涼、有補，針亦能汗、能吐、能下、能溫、能涼、能補。今須頓悟得破針理藥理，何物使之若此，又何以更無二致，方入妙境。

Acupuncture and Herbal Medicine, There Is No Difference, 1

With herbal medicine, there is diaphoresis, there is emesis, there is descending, there is warming, there is cooling, there is supplementation; acupuncture can also induce sweating, can induce vomiting, can descend, can warm, can cool, can supplement. Nowadays we must realize the truth that we need to destroy [the distinction between] acupuncture theory and herb theory, and whatever makes it like this, and furthermore [show] how there is no difference, only then can we enter into a [state of] profound understanding.

Mulch comments: This really piqued my interest. Of course, there is a difference between acupuncture and herbal medicine, which he does acknowledge as he continues. Though the methods are unique to each, the objectives and principles are the same, and there are correspondences between the two.

針藥兼有二

藥有氣有味，有厚有薄，有升有降，有陰有陽，有入肝、入心、入脾、入肺、入腎之殊，為木、為火、為土、為金、為水之異。針有浮有沉，有疾有徐，有動有靜，有進有退，有刺皮、刺脈、刺肉、刺筋、刺骨之殊，取井、取滎、取俞、取經、取合之異。針藥二途、理無二致。

[What] Acupuncture and Medicinals Both Have, 2

Medicinals have qì [nature] and wèi [flavor], have thick and thin [flavors], have ascending and descending, have yīn and yáng; have particular entry into the liver, entry into the heart, entry into the spleen, entry into the lung, or entry into the kidney; may specially be wood, be fire, be earth, be metal, or be water. Acupuncture has floating [superficial] and sinking [deep], has quick and slow, has moving and still, has advancing and retreating; has puncturing [the level of the] skin, puncturing [the level of the] vessels, puncturing [the level of the] flesh, puncturing [the level of the] sinews, puncturing [the level of the] bones. One can specifically select the jīng-well, select the yíng-spring, select the shù-stream, select the jīng-river, or select the hé-sea [points]. Acupuncture and medicinals are two paths but there is no difference in the principles.

Mulch comments: Instead of choosing medicinals for their qì and wèi or directional qualities, acupuncturists have needle techniques and point selection. Channel entry is, of course, a given in acupuncture, and so fits in both therapies.

Floating and sinking may refer to depth of insertion; advancing is increasing the depth of insertion, retreating is decreasing the depth of insertion (Versluys, 2004), moving/still and quick slow refer to the amount of manipulation and the speed of insertion and removal of the needle. As for the tissue levels, they can be imagined in this way [insert graphic]:

Needling Methods and Principles

Much of the correspondence between acupuncture and herbal medicine in the text is given with regard to classical needling methods, rather than point actions. Here, for example, in the ninth subsection:

針藥治同九

藥家熱者寒之，寒者熱之，實者瀉之，虛者補之，陷下者升之。針家熱則疾之，寒則留之，實則迎之，虛則隨之，陷下則灸之。針藥異途，治則同也。

Acupuncture and Herbal Medicine Treat the Same Things, 9

Medicinals are cold in cases of heat, hot in cases of cold, draining in cases of repletion, supplementing in cases of vacuity, ascending in cases of falling down. For acupuncturists, heat conforms to quick [needling], cold conforms to retention, repletion conforms to meeting [needling against the channel flow], vacuity conforms to following [needling along the channel flow], falling down conforms to moxibustion. Acupuncture and herbal medicine are different paths but the treatment follows the same [principles].

Another example in this vein, from the 28^th subsection:

藥有炮炙針有作用二十八

明醫治病，必主官方。方必君臣佐使，藥必精良炮炙。欲其入血，則炮以酒；其行痰，則炮以姜；欲其入肝，則炮以醋；欲其入腎，則炮以鹽，此一定之法也。刺家定其經穴，則官方也；穴有陰陽配合，則君臣佐使也；穴得其正，則精良也；刺合於法，則炮炙也。故循捫以攝氣，彈怒以致血，爪下以取榮，伸提以及衛，皆作用之法也。針之有作用，猶藥之有炮炙也。不知作用者，用生藥之醫也。穴失其正者，藥未精良也。不知陰陽配合者，方之無君臣佐使也。

Medicinals Have Pào Zhì, Acupuncture Has Actions, 28

When the enlightened physician treats disease, his formula must have a hierarchy. The formula must have a sovereign, minister, assistant and courier, the medicinals must be of excellent quality and be properly prepared (pào zhì). If one wants to enter the blood, roast with wine; if to move phlegm, then roast with ginger; if one wants to enter the liver, then roast with vinegar; if one wants to enter the kidney, then roast with salt, these methods are a given. The acupuncturist decides on channels and points, these then are the hierarchy; the points have yīn and yáng correspondences, this is the sovereign, minister, assistant and courier; if the points are correct, this is the excellent quality; if the needling is suited to the method, this then is the pào zhì. Therefore, abide by covering [the point] to contain the qì, pluck vigorously to reach the blood, scratch below [the point] to obtain the róng [provisioning/ yíng qì], extensively lift [the needle] to attain the wèi [defensive qì]; these are all actions of the method. Acupuncture has these actions like herbal medicine has pào zhì. Those who don't know these actions are like physicians who use unprocessed medicinals. Those who miss the correct points, [it is as if they] are using medicine of low quality. Those who don't know how to match and combine yīn and yáng, [it is as if they use] prescriptions with no sovereign, minister, assistant and courier.

Mulch comments: What I find interesting here, besides the overall idea of comparing formula composition and especially medicinal preparation to the elements of an acupuncture treatment, is the specificity of some of the techniques discussed – to affect the blood, róng/yíng, and wèi qì. I tend to rely on a fairly limited repertoire of techniques, so I am game to try a few of these out.

Channel Selection and Principles

My own inquiry into the application of treatment principles to acupuncture has been largely focused on the selection of channels and points, rather than technique. The following passage was, in that regard, of the most interest to me:

針藥自然之理十

藥之升陽者皆汗，沉陰者皆下，甘溫者皆和，苦者皆湧泄，淡者皆滲利，辛者皆散，酸者皆收，咸者皆潤，自然之理也。刺家補太陽、陽明則汗，瀉陽明、太陰則下，調少陽、厥陰則和，補陰維則湧逆，瀉陰蹻則滲泄，搖動皆散，靜留皆收，引而致之皆潤，亦自然之理也。

Acupuncture and Herbal Medicine Natural Principles, 10

Ascending medicinals all produce sweating, sinking yīn [medicinals] all descend, sweet and warm all harmonize, bitter all eject and discharge, bland all percolate and disinhibit, acrid all scatter, sour all contract, salty all moisten, these are their natural principles. For needling, supplementing tàiyáng [and] yángmíng conforms to sweating; draining yángmíng [and] tàiyīn conforms to descending; regulating shǎoyáng [and] juéyīn conforms to harmonizing; supplementing yīnwéi conforms to ejection and counterflow; draining yīnqiāo conforms to percolating and discharging; shaking and stirring [the needle] scatters; quiet retention contracts, leading to moistening; these are also natural principles.

Mulch comments:

A few random thoughts on the conformations in this passage:

• Sweating (diaphoresis): Supplement tàiyáng and yángmíng. Tàiyáng stage of Shāng Hán Lùn [Discission of Cold Damage] is, of course, one of the prime applications of warm acrid sweat-inducing herbs. In yángmíng stage, copious sweating is a major symptom, so sweat-inducing is not a common principle here. However, sweat has its basis in blood, and I note that the points of the Sea of Blood are UB11, ST37, and ST39, which are tàiyáng and yángmíng channel points.

• Descending: Drain yángmíng and tàiyīn. Another association of the character 下 is to purge, though I think the author’s intent was more broad than just purgation. Energetically, the stomach, large intestine and lung all descend, and only the spleen rises; the latter brings to mind the idea in formula composition of an oppositional assistant, a windup to the throw, a little yáng to enhance the yīn. This is the channel combination for the well-known protocol Miriam Lee’s 10 points (Lee, 1992).

• Harmonizing: Regulate shǎoyáng and juéyīn. This is a channel combination I use every day, to harmonize and quicken the blood as well as to regulate qì. The ur-formula for the harmonizing category is Xiǎo Chái Hú Tāng, which is the principal prescription for the shǎoyáng stage.

• As for the extraordinary vessels, the conformation of the yīnwéi vessel with ejection and counterflow seems more suited to its paired vessel, the chōng mài. It may be that the association of yīnwéi with upwelling, ejection, and counterflow and the correspondence of yīnqiāo to percolating and discharging have more to do with the actions of their jiāohuì xué or confluent points (PC6 and KD6) than the classical descriptions of pathology in those vessels (see, for example, Chace & Shima, 2010).

• The needle techniques: Active manipulation conforms to a yáng action of scattering or dispersing. Leaving the needle in place is a yīn gesture; I note the word shōu 收 also has the sense of “gathering” and “receiving” in addition to the Wiseman term “contraction”.

Conclusion

There are some interesting and potentially useful ideas in these passages. The concept of correspondences between acupuncture and herbal medicine are not, as I once thought, something wholly modern, but part of a thought stream dating back at least four centuries. I look forward to finding out more.

That’s all I’ve got for now. Thanks, as always, for reading.

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Note: this publication is for information purposes only and is not intended as medical advice. Please seek the opinion of a health care professional for any specific medical issues you may have.

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References

Chace, C., & Shima, M. (2010). An exposition on the eight extraordinary vessels: Acupuncture, alchemy, and herbal medicine. Eastland Press.

Lee, M. (1992). Insights of a senior acupuncturist: One combination of points can treat many diseases. Blue Poppy Press.

Versluys, A. (2004). The needling techniques of Xu Feng. Journal of Chinese medicine, 75,30-35

Wiktionary. (n.d.). 收. Retrieved February 17, 2024, from https://en.wiktionary.org/wiki/%E6%94%B6

Wiseman, N. (2022). Chinese-English Dictionary of Chinese Medical Terms. Paradigm Publications.

Wu, K. (1618). Zhēn fāng liù jí. Retrieved January 13, 2024, from https://jicheng.tw/tcm/book/%E9%87%9D%E6%96%B9%E5%85%AD%E9%9B%86/index.html