fredag 3 maj 2013

Interview with Dr Wang Juyi on channel theory in Chinese medicine, part 1

This article and interview is the first instalment of three about Dr Wang Juyi. They will focus on his experiences from fifty years in Chinese medicine, his long-time research and work – especially his system of channel palpation – his point-pairs and his views on how needling and Chinese medicine should be practiced. The second article coming in 2013 will include further interview with Dr Wang, a deeper look at his channel palpation-system and point-pairs, and a discussion about how the Six Levels of Chinese medicine are activated in qigong- and internal martial arts practice. The third instalment will be an interview with one of Dr Wang´s most long-term foreign students, US-based acupuncturist and Chinese medicine-teacher Yefim Gamgoneishvili, who after fifteen years of study with Dr Wang recently closed his New York clinic and moved to Beijing to do a further intensive two years of study at Dr Wang´s clinic, and at the hospital where he still works.



This year, Dr Wang Juyi has worked as a doctor in Chinese medicine for fifty years. He became known in the West through the book Applied Channel Theory in Chinese Medicine, written with his apprentice Jason Robertson. Dr Wang is famous for his research into the clinical application of Chinese medicine, his appreciation of the Chinese medical Classics, his system of channel theory and palpation, and his constant wish that his students surpass him in skill through applying these principles. This is the first article and interview where we begin looking at Dr Wang´s system and his own historywhich spans half of the 20th century of Chinese medicine into the 21st.

Dr Wang Juyi graduated with the first university class in Chinese medicine in 1962. His teachers were all trained in older styles of Chinese medicine, among them names that later became famous in the West too, like master herbalist Qin Bowei and ”Golden Needle” Wang Leting. Dr Wang´s working life has been in the state hospitals in China; he has seen TCM be created out of the Classical Chinese Medicine (CCM), been head of the hospital he worked, editor of Chinese Acupuncture (Chinese version of the Lancet for Chinese medicine) and finally gone into privat practice in Beijing, which he still maintains. Today, he is 75, tall, with good energy and a strong, gravelly voice. He takes obvious joy in transmitting his research and knowledge to younger generations, and really wants to help us deepen his research into both the Chinese medical Classics and into other clinical applications of Chinese medicine.

How come you went into Chinese medicine to begin with?
  Dr Wang laughs.I didn´t know anything about it. My maternal grandmother got sick and died, which affected me and my mother a lot. I found out later that the doctor had misdiagnosed her, because his skill was low, and he had given her a bad treatment. It seemed an important skill to me to have good doctors. So, first I had the desire to become a doctor. I then thought about it for a few years. At the time, I didn´t even know the difference between xiyi (Western medicine) and zhongyi (Chinese medicine), I just thought it would be great to be a good doctor and be able to extend the lives of people who were ill.

When I saw Western medicine, I didn´t like it that much. Chinese medicine, though, inspired me. I didn´t understand much of it at the beginning, but I kept reading anyway.He studied for three years, then a further three into six years. They read philosophy, history, the Neijing and other medical classics, different schools, and the huge bank of clinical knowledge that builds up Chinese medicine.

 
Personal experiences with Chinese medicine
 
There were four choices, and all his classmates were surprised when Dr Wang chose Chinese medicine.Later on I thought about this,he says,and realized that one reason was that back in 1946-47, my mother was treated for problems during menopause, and treated with herbs by a doctor called Li Guohua. Dr Li came home to us by rickshaw, carrying herbs. Then she recovered in April, but later started wheezing a bit, windy, with bad hives and swollen cheeks, and Li Guohua again came and treated her for 2-3 days with herbs, and she had no relapse after that.

Li Gonghua later came to treat myself too. When I was at boarding school, I got a high fever in a late stage of an illness. I went home and literally expected to die. They called Dr Li to our house. He said it was a very grave condition, very serious, and that it might help or might not, but we could try for 2-3 days. I slowly got better, and finally had a month-course of Li´s herbs. I think both these events gave me a subconscious focus on Chinese medicine later on.
  His grandfather knew a bit of Chinese medicine, but he didn´t treat much with it. Back before the Cultural Revolution, many educated had a bit of Chinese medical knowledge. His grandfather was self-taught from books. He had a lot of notebooks, pills, herbal medicines and herbal plasters. Dr Wang still has some of them left.
  And that background was probably what made him gravitate towards Chinese medicine. But this turned out to only be the start of a long and exciting journey.


Channel palpation and channel theory

In 2012, Dr Wang held a longer course on his system of channel palpation and channel theory in Dublin. It was hosted and arranged by Cyrille Bonnard, along with a small group of helpers, and pulled in a good group of enthusiastic practitioners who spent four days learning Dr Wang´s system and drinking deeply of the knowledge in Chinese medicine he has gathered over the last 56 years. We were helped greatly by Mei Li, one of Dr Wang´s apprentices, who with her translation and further explanations made the course even better.

The channels determine life and death, play a role in all disease and regulate deficiency and excess; they must be free of obstruction.                 
                        – Neijing Lingshu, chapter 10, Jingmai, On Channels. Wang Bing version, 762 AD, Tang Dynasty. From Yellow Emperor´s Canon of Internal Medicine, transl. by Wu and Wu, China Science and Technology Press, 2005


Channels or meridians are two ways of translating the Chinese term jingluo. Jingluo covers both the so called Primary Channels (jing) and the smaller networks, the Collateral Channels (luo). ”Meridian” comes from the french translation méridienne with the idea of the mercator meridians surrounding the globe, but jing actually has the connotation of the warp and weft in fabric and cloth. Jingmi, for example, is ”warp density, ends per inch”, jinglun ”to comb and arrange silk threads”. In most Chinese medical Classics, the channels are often likened to canals and drainage ditches in a farming landscape.

There are then also deeper channels than these – the next deeper level the jingbie, the Divergent Channels, and at the deepest levels, the qijing ba mai, the Eight Extraordinary Channels. Daoist spiritual work and some qigong add deeper ones still after these.
  The qi and connections of information that are the channels go through our physical tissue. Changes in health in an organ will show as a change on its associated channel; it is a system for mapping and palpating these changes that Dr Wang has made part of his life´s work.


What happened to channel theory?
 
During the course, Dr Wang started off with an introduction to channel theory and his views on why it has been lost. He asked how long time everybody had practiced.
  After a chorus of answers, he said,If you have that training and experience, why do you need to be here studying with me today? It means your knowledge in channel theory is probably either incomplete or not detailed enough. This lack of understanding of channel theory exists in China too. I had the same problem when I started out.

In Japanese acupuncture, palpation has remained much more vibrant over the centuries, with an especially strong focus on abdominal palpation and diagnostics. The Chinese version of channel theory and palpation was deeply studied in older chinese medicine and seen as crucial there, but then came and went depending on what dynasty it was. The 20th century became a weak era for it in China.
 
Dr Wang got a lot of information and skills from his university studies, but found it very difficult to get good results without channel theory. When he started out he didn´t believe in channels. Then slowly he began to understand the importance of them in Chinese medicine, and over time, went deeply into researching them.
 

It´s not your fault”
 
It is not your fault if you lack information on this subject. In this point in time, channel theory has either been ignored or forgotten. There are two ways for most acupuncturists to understand pointsexperiential points, where a function has been tried and tested in clinic in a specific tradition or style. Then there is looking the point functions up in books. But when they don´t work, the doctors who taught the experiential points can´t be askedthey´re dead, like my father and grandfather are.

In clinic, he found that with these two versions, sometimes it worked, sometimes it didn´t. The failure of those two methods plagued him for many years. But channel theory explained them and gave a deeper understanding of how points actually worked. It also increased the effect of his treatments, suddenly making most of them work all the time and with much better effect. It was through his studies of that from the Classics and the huge amount of patients that often is standard in Chinese hospitals, that he realized that Chinese medicine had a very strong theoretical foundation in channel theory. During his decades in the hospitals he also saw many acupuncture doctors who quite quickly went on to do herbal medicine instead of deeply researching the acupuncture system, often because they misunderstood it as too simple, and because they lacked a cohesive whole through which to understand the treatments.

Don´t make the mistake that using more acupuncture points is better. It is quite harmful to the body.”                     
                         Dr Wang Juyi in lecture


Don´t traumatize the point”
 
Life is like a good instrument," Dr Wang said one afternoon. "You have to play it well. Needling is like playing the violin. A gentle, very refined movement. You are not needling any tissue, you are needling the areas between tissues. If you have the right technique when playing the violin, you can produce the best sounds.

Over the course Dr Wang used the simile of playing an instrument several times. He encouraged the students to think deeply about it, and make their skills gentle with patients. Needling, he repeated, should not be painful or hard.Life is a very gentle instrument.

Needling is like playing the violin.”                           
                     – Dr Wang Juyi in lecture


Just as he taught this, he also taught how to use other point pairs tostrumthe patients system:If strings are loose, you have to tighten the strings on the violin before you can play it.
  During the palpation lessons his phrase was,You want to ice-skate, not tap-dance. Each point location should be based on palpation skills, and each location will be guided by several of the five different tissues. We will look at these in the next instalment in this series, in the next issue.

Some in chinese medicine who don´t get effect, they just needle deeper...Dr Wang said he has seen this uncountable times in China in the hospitals where he worked, and he thinks it is a sign that the practitioner doesn´t understand Chinese medicine.
  Part of his palpation system is how to open the point (kaixue) before needling, and how to help open the channel to make sure the treatment effect is even more precise. Classical Chinese Medicine-practitioner and Daoist priest Jeffrey Yuen has a great phrase to remember: Don´t traumatize the point.


Courses with Dr Wang in Europe 2013
 
Dr Wang Juyi will be returning to Europe in June 2013. One of the courses will be in Dublin, arranged again by Cyrille Bonnard. This time there will be two courses, one for people who have attended previous trainings with Dr Wang, and one for students who want to have a first look into the system and Dr Wang´s experience from half a century working in Chinese medicine. You can read more and book your place at http://www.equilibreacupuncture.ie/education/index.php 

Part 2 of this article will appear in the next issue of Tai Chi Chuan and Oriental Arts Magazine in the UK. Then we will look more at Dr Wang´s channel theory, specifics of palpation, how the channel theory weaves together with qigong- and IMA-practices and take a closer look at Dr Wang´s research into point-pairs, a way of treating that makes acupuncture treatments simpler yet more effective.
 
The Yellow Emperor answered: The state of the channels and vessels determines life or death. Hundreds of diseases are managed (according to their condition), and emptiness and fullness are regulated through them. Therefore one cannot be unfamiliar with them.
                Jia Yi Jing, the Systematic Classic of Acupuncture and Moxibustion, Chace and Yang, Blue Poppy Press 1993

 
Daniel Skyle © 2013. Daniel Skyle is a student of Dr Wang Juyi. He has trained in Daoism, qigong, the internal martial arts and chinese medicine for more than twenty years. He currently has two clinics in Sweden where he works with Classical Chinese Medicine and acupuncture. His blog can be found at www.acupractitioner21.blogspot.com.
 

The acupuncture points have become my friends over the years

When I first began studying, I believed that points were just measured places on the body that might be located on a cadaver or in an anatomy text. Also, I believed that all points on the body were roughly the same: that they are all openings between the various structures of the body. Later, I began to appreciate subtle differences among the points. Some have more qi or more blood, some have less. In some places the type of qi is different than in others. Importantly, the exact nature of qi sensation that should be generated from each point varies, and should be varied depending on the desired effect. Each point actually has its own nature or personality. Once I began to truly note these differences among the points on my patientes, I became more and more interested in the classical point categorizations. It is from here that I began my explaration of the source, collateral and five transport points.

In fact, after many years, I now think of many of the points on the body as old friends. I know what they are like, what their strengths and weaknesses are, and when to call on them for help. When you get to know the points in this way, treating in the clinic is kind of like waking good friends from a slumbergently prodding the points to wake them up and send them on their way. Also, as I´ve said before, some of the points are like jacks-of-all-trades, friends that you might call on to help with a wide variety of projects. Other points have very specific strengths and should be used in more specific cases. The points, to me, really do seem to have these different personalities.

- Extract from Applied Channel Palpation in Chinese Medicine by Dr Wang and Jason Robertson. It can be bought here on Amazon: http://www.amazon.com/Applied-Channel-Medicine-Lectures-Therapeutics/dp/0939616629/ref=sr_1_1?s=books&ie=UTF8&qid=1341144742&sr=1-1&keywords=wang+juyi



Daniel Skyle © 2013. First published in Tai Chi Chuan and Oriental Arts, Winter 2013