|Year : 2018 | Volume
| Issue : 1 | Page : 46-48
ResearchCenter on Chinese medicine in the West (CRAOMC), California, USA
|Date of Web Publication||3-Jul-2018|
Dr. Peter Eckman
Centre de Recherche sur les Apports occidentaux à la Médecine chinoise, California
Source of Support: None, Conflict of Interest: None
A new style of acupuncture, named constitutional/conditional acupuncture (CCA), based on traditional Asian medical practices, was revealed in Kunming in 2017. This method is primarily based on pulse diagnosis, as developed in China, Korea, and India. The basic methods of CCA are briefly described, and a few case results from the 3-day Kunming workshop are presented to reveal the efficacy of CCA.
Keywords: Ayurveda, condition, constitution, Korean acupuncture, Mai Jing, Nan Jing, Nei Jing, pulse diagnosis, renying cunkou diagnosis, sasang constitutional medicine, traditional Chinese medicine, Yi Jing
|How to cite this article:|
Eckman P. Constitutional/Conditional acupuncture. Chin Med Cult 2018;1:46-8
Traditional Chinese medicine (TCM) is based on classical texts from several 1000 years ago. They include descriptions of several different methods of pulse examination and diagnosis; however, other Asian countries have also developed examination and diagnosis methods based on the pulse, which differ from those originated from China. Over the past 40 years, I have been practicing acupuncture with a view toward understanding the relationships of these different pulse methods. This research has eventuated in a new style of acupuncture named constitutional/conditional acupuncture (CCA). A preliminary text explaining the details of CCA was published by Singing Dragon Press in 2014 as The Compleat Acupuncturist and was further elaborated in Grasping the Donkey's Tail, also published by Singing Dragon in 2017.
In October 2017, I was invited by Professor He Ting to conduct a 3-day clinical workshop on CCA in Kunming China at the Sheng-Ai Hospital of TCM, organized by the Yunnan University of TCM. Seven patients were treated for 3 days as a course of treatment, and they all returned afterward for therapeutic effects evaluation. In all cases, there was a noticeable improvement, even in those who had been previously treated in vain by other approaches such as acupuncture and Chinese medicine. A full report of this workshop has been submitted for publication to a peer-reviewed professional journal, but for now, it is worth sharing a few of remarkable results. For example, a 35-year-old woman who previously cannot stand unaided for 2 years resumed the ability of walking; a 37-year-old woman suffering from severe rheumatoid arthritis for 4½ years had complete pain relief in multiple joints [Figure 1].
The pulse examinations used in CCA are very briefly described below, and they consist of techniques that are predominantly from China, Korea, and India.
- Korean Sasang medicine (derived from the Chinese Yijing) posits 4 Constitutional types (Soyangin, Taeyangin, Soeumin, and Taeumin), which can be diagnosed by comparing the reactions to holding four different foods with which they resonate (cucumber, banana, potato, and carrot, respectively). Kinesiology, in the form of Professor Yoshiyaki Omura's O-Ring test, is one way to distinguish these types. If the food resonates with the individual's constitutional type, then the O-Ring test will show better neuromuscular coordination. There is also a method of pulse diagnosis developed by Puramo Chong, one of my Korean teachers, which can be used to confirm this finding. For me, these findings indicate the following relationships: Soyangin has an Earth element stronger than its water wlement; Taiyangin has a metal element stronger than its wood element; Soeumin has a water element stronger than its Earth element and Taeumin has a wood element stronger than its metal element. These relationships obviously reflect five element (wu xing) theory, which was not recognized by Li Jema, the originator of Sasang medicine. However, my reinterpretation of Sasang typology is fundamental to the understanding of the constitution in CCA
- Book 10 of the pulse classic Mai Jing ( Pulse Classic) describes locations for perceiving the pulses of the meridians (jingmai) of the zangfu. The positions where these pulses may be felt can be described as radial or ulnar “deviations” in the locations of one of the three standard pulse positions known as cun, guan, and chi. Two of these positions can be observed to form a line parallel to the flexor tendons, while the third is in a place either closer to or further away from the tendon. This deviation remains the same whether the individual is in health or illness, so I understand it as reflecting the individual's Constitution, specifically regarding the six types of yinyang meridians and their associated organs (Taiyang, Shaoyang, Yangming, Taiyin, Shaoyin, and Jueyin). This set of associations of organs to the locations cun, guan, and chi do not replace the standard associations, but rather describe a different aspect of their energetics [Figure 2]
- In 1965, a Korean acupuncturist named Kuon Dowon presented a new approach to acupuncture, based on his discovery of 8 pulse types that never changed in any individual during their lifetime. He called his method Korean constitutional acupuncture (KCA). I studied directly with Kuon at his clinic in Seoul and has subsequently concluded that Kuon's discovery of these 8 pulse types is accurate. However, it is my discovery that each of these pulse patterns can reflect two or three different constitutions, so additional examinations are needed to identify the exact constitution. The location for taking the KCA pulses is in positions 4, 5, and 6, further proximally along the radial artery than cun, guan, and chi. The KCA pulses are felt by pressing on the artery to obliterate the pulse, then releasing the pressure to feel where the pulse first emerges [Figure 3]
- Ayurvedic medicine from India also has a theory of Constitutional types, which can be diagnosed via the radial pulse. Interestingly, ayurvedic constitutional pulse diagnosis shares several features with KCA pulse diagnosis. Both systems examine the pulse in the same proximal locations that are referred to as positions 4, 5, and 6. Furthermore, both systems diagnose the constitution by examining the deepest impulse at these three positions. Ayurveda uses a concept of 3 Doshas, which is not directly equivalent to any parallel idea in Chinese medicine; however, it is possible to find correspondences between ayurvedic and Chinese medical designations as I explained in The Compleat Acupuncturist. The three Doshas are Vata, Pitta, and Kapha. These Doshas can be present at the constitutional level either singly or in couples. Thus, there are 6 possible ayurvedic constitutional types as follows: Vata, Pitta, Kapha, Vata/Pitta, Vata/Kapha, and Pitta/Kapha [Figure 4]. By using a combination of these first four diagnostic findings, not only it is possible to determine the specific constitution in terms of which of the five elements is at the root but also specifically which organ (or official) is involved, and if it tends toward excess (hyperfunctioning) or deficiency (hypofunctioning), along with the relative strengths or weaknesses of all the other elements and organs. The following steps in the pulse examination are intended to provide information about the current state of the qi mechanism (the condition), as any initial excess will provoke a deficiency elsewhere and vice-versa, consonant with basic yinyang theory
- The original pulse diagnosis paradigm that was clearly described in the Nei Jing ( Internal Classic) was the comparison of carotid and radial arteries at acupoints ST 9 and LU 8, named Renying Cunkou diagnosis (RYCK) after the places where the pulses of these arteries are compared. Bigger RY than CK indicates either yang excess or yin deficiency, while bigger CK than RY indicates either yin excess or yang deficiency. The exact proportions between RY and CK can more narrowly identify which of the six yinyang meridians is signaling an imbalanced condition. The reason I classify this method of pulse diagnosis as conditional is that after treatment, this RYCK ratio can be observed to change. Indeed, this is stated as an expectation in the Nei Jing, so it is not an invariant signal like the first 4 listed above
- Nan Jing ( Classic of Difficult Issues) chapter 5 presents the associations of body tissues (skin, vessel, flesh, tendon, and bone) and organs (LU, HE, SP, LV, and KI), implying their five element correlations, with the amount of pressure exerted by the examiner's fingers at the cun, guan, and chi positions. The greater the pressure, the deeper the level where the pulse is examined. In a state of health, the depth where the pulse is biggest should match its elemental correspondence. Thus, the left cun should be felt at the vessel depth, which corresponds to fire. If it is felt at the bone depth (corresponding to water), there is an imbalance between Fire and water elements. This method of examination can be refined even further by slightly shifting one's fingers either proximally or distally at cun, guan, and chi. I have found that the distal placement of cun, guan, and chi reflects the situation in the yang meridians associated with the Fu organs, while the proximal placement of cun, guan, and chi reflects the situation in the yin meridians associated with the zang organs. Both yin and yang finger positions for cun, guan, and chi give accurate information when applying the ideas in Nan Jing chapter 5. One goal of CCA treatment is to return these pulse depths to their proper elemental level, and this can be used as a guide to a successful treatment
- Perhaps, the most difficult part of the conditional pulse examination is the more superficial level of the ayurvedic pulse, known as the Subdosha level. Each of the three Doshas is in turn comprised five Subdoshas, and I have discovered that the locations on the examiner's fingers where the different Subdoshas might be felt follow a strict order. It happens that this order reflects the xiang ke (control cycle) order of the elements so that a Subdosha finding can be translated into a Chinese elemental signal. My experience is that most often the constitutional element's Subdosha will be found on one radial artery, while the conditional element's Subdosha will be found on the opposite side's radial artery. These findings are even more specific than just identifying the element involved. They actually reveal the organ producing this signal, assuming one already knows the individual's constitution, and thus their elemental tendencies toward excess or deficiency.
This new style of acupuncture is in fact heavily indebted to ancient Chinese doctrines, and is best viewed as an expansion of those basic ideas, resulting from the clinical experiences of countless practitioners since antiquity, down to modern times. I have conducted clinical workshops to reveal and teach CCA in the USA and Spain during the past 2 years, in addition to the workshop in Kunming, and is eager to conduct similar classes wherever there are interested students and practitioners.
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Conflicts of interest
There are no conflicts of interest.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]