Dao of Chinese Medicine

366 Pages·2002·53.95 MB·English

by  Donald Kendall

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Dr. Donald (Deke) Kendall first became involved
with Chinese medicine after graduating from the
University of Illinois with a degree in engineering,
when he adopted the use of Chinese herbs as his
primary health care strategy. This led to the study
of physiology and Chinese medicine, culminating in
a degree from the California Acupuncture College
as Doctor of Oriental Medicine (O.M.D.) He has
since fully incorporated the principles and practices
of this ancient healing art into his life. He is now
considered one of America's leading experts on
Chinese medicine, with more than twenty years of
private clinical experience, including acupuncture
research at the UCLA dental school and as a staff
member at the UCLA's Center for East-West Medicine.
Dr. Kendall has also served on the boards of several
state and national professional organizations
for acupuncture and Oriental medicine. He has
developed and taught acupuncture orthopedics and
dental acupuncture certification courses, and has
participated in veterinary medical acupuncture
training programs. He lectures extensively around
the United States, as well as internationally, and has
published a number of articles on various aspects
of Chinese medicine, with an emphasis on how
acupuncture works. This book represents a large
part of his experience, expertise, and enthusiasm.
Jacket design by Lea & Ink Design
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OXFORD
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OXFORD
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Dedicated to the ancient Chinese physicians,
and subsequent practitioners,
whose genius gave the world the great treasure of Chinese medicine.
Contents
Preface xi
1 In Search of the Dao 1
Early Western Exposure
Authenticity of Chinese Medicine
Toward Understanding
2 Ancient Beginnings 16
Out of the Stone Age
Emergence of the Zhou Dynasty
Early Medical Concepts
Medicine as a Rational System
Celebrated Texts
3 Early Understanding of Physiology 30
Postmortem Studies
Skeletal and Body Measurements
Function and Classification of Internal Organs
Anatomical Information on Internal Organs
Physiological Relationships
Nerves in Ancient Times
4 Qualities of Opposition 56
Classification of All Things
Anatomical Notation in the Yin-Yang System
View of Internal Organs
Dynamic Interplay between Yin and Yang
5 Need for Medicine 73
Cause and Treatment of Disease
Development of Therapeutic Approaches
Medicines for Internal and External Use
Needling Therapy (Acupuncture)
Heating Therapy
Physical Medicine
Prevention and Rehabilitation
6 Interaction of Sky and Earth 89
Dynamic Forces of Evolution
Interaction of Earth Phases
Products of the Soil
Flavors in Health and Disease
Herbal and Dietary Therapies
viii CONTENTS
7 Spirit, Vitality, and Emotions 111
Role and Meaning of Spirit
Origin of the Spirit
Organ Vitalities and Emotions
Organ Vitalities and Endocrine Glands
8 Basic Substances and Metabolism 128
Vital Substances
Body Fluids
Role and Function of Blood
Key Metabolic Features
Overall Metabolic-Processes
9 Vessels and Collaterals 144
Vessel Organization
Singular Distribution Vessels: jimai
Communication Vessels: Shumai
Main Distribution Vessels: jingmai
Collateral Vessels: Luomai
Fine Vessels: Sunmai
10 Blood Circulation 167
Role of the Heart in Circulation
Nutrient Circulation Cycles
Circulation of Defensive Substances
11 Distribution Vessels and Nodal Pathways 182
Anterior Vessel and Nodal Pathways
Vessels of Anterior Medial Hand: Lungs
Vessels of Anterior Lateral Hand: Large Intestine
Vessels of Anterior Lateral Foot: Stomach
Vessels of Anterior Medial Foot: Spleen
Posterior Vessel and Nodal Pathways
Vessels of Posterior Medial Hand: Heart
Vessels of Posterior Lateral Hand: Small Intestine
Vessels of Posterior Lateral Foot: Bladder
Vessels of Posterior Medial Foot: Kidneys
Medial and Lateral Vessel and Nodal Pathways
Vessels of Medial Hand: Pericardium
Vessels of Lateral Hand: Internal Membrane
Vessels of Lateral Foot: Gallbladder
Vessels of Medial Foot: Liver
Deep Singular Vessel Nodal Pathways
CONTENTS ix
12 Muscle Distributions 214
Features of the Muscular System
Longitudinal Distribution of Muscles
Muscles of Posterior Lateral Foot: Bladder
Muscles of Lateral Foot: Gallbladder
Muscles of Anterior Lateral Foot: Stomach
Muscles of Anterior Medial Foot: Spleen
Muscles of Posterior Medial Foot: Kidneys
Muscles of Medial Foot: Liver
Muscles of Posterior Lateral Hand: Small Intestine
Muscles of Lateral Hand: Internal Membrane
Muscles of Anterior Lateral Hand: Large Intestine
Muscles of Anterior Medial Hand: Lungs
Muscles of Medial Hand: Pericardium
Muscles of Posterior Medial Hand: Heart
13 View of Health and Disease 239
Physiological Balance and Homeostasis
External and Internal Assault
Environmental Pathogenic Routes
Manifestations of Disease
Clinical Presentation
Differentiation of Syndromes
14 Mechanisms of Action 256
Tissue Response to Needling
Nociceptive Activation
Propriospinal Participation
Somatovisceral Relationships
Controlling Pathways
15 Treatment Approaches 286
Principles of Treatment
Prima1y and Seconda1y Manifestations
Therapeutic Methods
Needling Therapy
Use of Critical Nodes in Treatment Strategies
Frequency and Number of Treatments
Standards of Practice
Notes 309
List of Tables 313
References 317
Index 336
Index to Neijing Citations 351
xii PREFACE
Western interest in Chinese medicine and acupuncture has increased steadily since the
1960s and 1970s; some countries now license practitioners specifically trained in this medical
art. In the year 2001, while some areas of the United States do not yet permit its practice
except by conventionally trained medical doctors- most states do allow independent
practitioners. A great debate has ensued over the past decade in the United States whether
Chinese medicine, or at least acupuncture, needs to be recognized as a valid medical procedure.
In 1997, some 175 years after acupuncture was first introduced in America, the NIH issued a
Consensus Statement (No. 107; 1997 Nov 3-5; 15 (5): 1-34), which recognizes acupuncture as
a useful therapeutic intervention for a wide range of conditions. However, it also notes that
there are many inconsistencies in the research design of acupuncture studies, revealing the
major problem that has plagued Chinese medicine since its inception in the West four hundred
to five hundred years ago. Incomplete source material and poor translations have muddled
the st01y of Chinese medicine since it was first introduced in the West.
Accurately translating Chinese into Western languages, including Latin, was and still is a
challenge because the context of spoken and written Chinese, especially that of the ancient
written form, is often misunderstood. Chinese is more context-sensitive than most other
languages. For this reason many early and present translations are flawed. If the reader
understands the context of the sentence, paragraph, or chapter, or understands the context of
the subject presented-even though an abbreviated form or a substitution for the Chinese
term in question may be used subsequent to its first full reference-the true meaning can be
discerned. The critical point is to understand in what context the key terms are used; without
this, there is little chance of translating Chinese correctly or consistently.
Jesuit missionaries in the fifteenth century were the first to bring Chinese medicine, including
acupuncture, to Europe. The first text on the subject was written in Italy in the 1500s, based
on information gathered from people who had traveled to the Orient. The earliest first-hand
Western account of Chinese medicine was provided by the Dutch physician Willem ten Rhijne
in 1683, based on his two-year stay in Japan. He reported that the Chinese emphasized the
circulation of blood and vital air (qi, 9:) through the vascular system, and that Chinese physiology
involved blood vessels and netves. Ten Rhijne interpreted the Chinese concept of environmental
or pathogenic factors (xie, $) that affect the internal body as "airs" penetrating the body.
From this he incorrectly concluded that Chinese medicine was essentially the same as the
empirical ancient Greek concepts of Hippocrates and Galen that were held in disrepute
c.luring his time. Equating Chinese medicine with the outdated Greek ideas persisted in the
West until the 1930s. Then in the 1930s and 1940s the Chinese character for air (qi), or vital
air, was inaccurately interpreted as "energy," while the Chinese vascular system was replaced
with "meridians." These interpretations led to a whole new concept of Chinese medicine.
These fundamental errors have been responsible for much misdirection in trying to understand
the reality of Chinese medicine, and in the setting of design research protocol to verify its
basic theories.
After the energy-meridian idea was popularized, ten Rhijne's report about the involvement
of nerves and blood vessels in Chinese physiology was considered erroneous, and little
thought was given to the physiological basis of Chinese medicine. The great discoveries of
the ancient Chinese physicians, including blood circulation, organization of the cardiovascular
system, somatovisceral relationships (communication between the external body and the
internal organs), internal organ systems, immune system function, and the organization of the
musculoskeletal system, were obscured. Once modern research was applied to understanding