Dkaraba Neijing Tcmwt Handout
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TCM Wisdom TubeTM
Acupuncture from the Neijing
byDavid Karaba, L.Ac., O.M.D.
LEARN THE SCIENCE PRACTICE THE ART HEAL
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Acupuncture from the Huángdì Nèijī ng
( 黄 经 )The origins of needling therapy
and Acupuncture
Remembering our Roots
Honoring our Tradition
by
David Karaba, O.M.D., L.Ac.
Purpose
This webinar is the provide insight andperspective to the upcoming class:"Acupuncture from the Neijing for Fantastic
Clinic Results,“ By Dr. Donald Kendall nextweekend, 6/26/10!
Reviewed will be:
Essential Concepts and
Why we should expand our understanding
of the Huángdì Nèij ī ng (黄 内 )
Copyright
Pictures have been purposely removed from the
handout for copyright reasons
Overview
Keys to fully appreciate and grasp the subtleties ofthe Huángdì Nèij ī ng (黄 内 ) are:
– The importance and need for IntegrativeConcepts (.i.e. Why scientific understanding isessential for consistent repeatable results)
– Nomenclature used (and why)
– Longitudinal Organization
Huángdì Nèijī ng ( 黄
经 )
Yellow Emperor’s Internal Classic(Huángdì Nèijī ng
黄 内
经most
important text to evolve perhapsduring ca. 600 – 300BCE
Some evidence shows Neijing may havebeen compiled ca. 200 – 100BCE
The importance of the Huángdì Nèijī ng
( 黄 经
) First comprehensive Medial Text
Is a compilation (c.200 BCE) of all knowledgerelated to Chinese medicine
Provides an amazing understanding of humananatomy, physiology, and pathology
Provides first complete description of bloodcirculation by cardiovascular system and alsothe lymphatic system
Neijing provides foundation of needlingtherapy including description of 9 needles
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otus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: [email protected]
all not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute.
9 needles Used For:
– Needling - Blood letting - Minor surgery- Acupressure
Huángdì Nèijī ng ( 黄 经
)
Notes that ancient Chinese physiciansperformed postmortem autopsies
First account of continuous blood circulation
and rudimentary immune system
Provided anatomical measurements of internalorgans and blood vessels
Mentioned neurovascular connections to heartand eyes
Observed propagated sensations (PS) alongvessel and muscle distribution pathways
Huángdì Nèijī ng ( 黄 经
) First medical text to correctly describe:
– Cardiovascular blood circulation consisting of:
Inhaled air
Nutrients absorbed by small intestine veins
Hormones
Immune substances (wèi卫) (can leave circulation anddrain into lymphatic system)
– Brain, spinal cord, and peripheral nerves
– Longitudinal body organization with segmentaldominance (fundamental to all vertebrates)
– Longitudinal distribution of muscles and vessels
giving rise to neurovascular nodes (acupoints)
Huángdì Nèijī ng ( 黄 经
)
First medical text to correctly describe (cont):
– Internal organs
– Did not differentiate the endocrine glands but includedtheir functions, vitalities, and emotional contributionswith specific viscera
– Rational concept of pathology involving the interplay ofphysiological balance, external environment, andemotional stress and strain
Provided treatment approaches using:
Treatment based on herbs and needling therapy
– The character of “Yi” 醫
Others: exercise, breathing exercise, moxa,
Somatovisceral relationships, organ referred pain &
Organ Vitalities and emotions mediated by refined substances
(shen jing)[
精 ] Organ referred pain, four hollows, vessel distributions
– Significance with regards to needling
Vitality, emotions, and endocrine glands
– Zhi– drive; will - adrenals
– Hun – Mood – pineal (controlled by eyes)
– Po – vigor – thyroid
– Yi – intent; desire – pancreas
– Shen – spirit – heart; pituitary
Organ referred pain
To increase the blood flow and innervationfeedback
Viscerosomatic effects (organ referred pain)
Somatovisceral effects (treating the extremities
to effect the organs – needling patches, etc.)
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otus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: [email protected]
all not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute.
Fantastic Clinical Results
Some are due the results of unique
functions or capability of certainneurovascular nodes
Most are result of understanding uniqueview of body developed by the Chinese
Most important is longitudinal (经
) bodywith segmental nerve dominance
Western Exposure
Marco Polo (1275-1292),in a letter to the Doge ofVenice, mentioned“needles that cure”
Western Exposure
Jesuit Missionaries of the fifteenth centuryreported and practiced needling therapy
In the late 1600s Willem ten Rhijne was firstwestern trained physician to observe Chinesemedicine practice while serving the Dutch EastIndia Co. in Japan
He learned from practitioners that vessels involverelated nerves as well
Japanese physicians constructed hydraulic
machines to illustrate how blood continuallycirculates through the body
Western Exposure
Willem ten Rhijne also learned that branching ofvessels was a critical part of Chinese theory
He indicates that this branching was unknown inEurope at the time
He wrote a dissertation in 1683 on Chinese medicineand needling therapy
His report was used in early 1800 France, Italy, andUS to experiment with needling and electricstimulation to inserted needles
Western Exposure
During early 1900s a bank clerk from Francenamed Soulie de Morant spent several years inChina
Around 1930 he started teaching a few physiciansand lay people about his ideas of Chinese medicinein France
With no training in anatomy or physiology hemade several critical errors in his interpretation ofChinese medicine
Soulie de Morant
The most devastating error was to translate vitalbreath (qì气 [ ]) as “ ‘energy’ for lack of a betterword”
He then translated the longitudinal and collateralvessels (j ī ngluò经络) as meridian althoughmeridian is经线 j ī ngxiàn
He also then translated word for blood vessel (mài脉) as meridian as well
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otus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: [email protected]
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Original Chinese Discovery
Continuous circulation of blood to internal andsuperficial region by means of cardiovascularsystem
Branching of arteries into progressively smallervessels including capillaries which communicatewith return flowing veins
Vital breath circulated in blood along withnutrients, defensive substances, and biologicallyactive substances of vitality that mediate emotions
William Harvey
This developed the ideas of René Descartes who in hisDescription of the Human Body said that the arteriesand veins were pipes which carried nourishmentaround the body. Although Spanish physician MichaelServetus discovered circulation a quarter centurybefore Harvey was born, all but three copies of hismanuscript Christianismi Restitutio were destroyedand as a result, the secrets of circulation were lost untilHarvey rediscovered them nearly a century later.
Retrieved 1/1/19/07 @ http://en.wikipedia.org/wiki/William_Harvey
William Harvey (1578 -1657) was an English
medical doctor, who is credited with first
correctly describing, in exact detail, the
properties of blood being pumped around the
body by the heart.
In contrast – Four Great Inventions of China
History and origins
– Gunpowder was invented in China and is consideredone of the Four Great Inventions of ancient China.
The 'Four Great Inventions of ancient' China: the compass,gunpowder, papermaking, and printing.
The blood circulatory system is not included as anoriginal discovery (yet)….
From Wikipedia, the free encyclopedia
Integrating Medicine
Between the East and West
Bridging the Divide
A Need for Greater Understanding
Must be able to Communicate with allied
health providers – Standards of Care
Know the Self (i.e. know how the body works)
NIH 5 year plan
Things by mouth
Herbs botanicals
Diets Mind/Body (expectation / condition effecting any therapy)
Acupuncture, Chiro’s, Osteopathy
Energy Medicine – (Gov hasn’t invested much moneyin because it hasn’t been able to produce repeatablemodels) (lower Priority)
Whole medical systems – TCM, Native Americanhealthcare, Aryuveda, as opposed to the herb or the herbsor the modality used in the system (not reduce via an ultrareductionistic manner)
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NIH 5 year plan
(Three new)
International collaboration – joint efforts toinvestigate: reproducibility, improving
training,
Cost Effectiveness (Show me the money)
Ethical, legal (malpractice), and socialramifications of making CAM therapiesaccessible, advising patients to use them oravoid them, training people of advisedconversations with patients
NIH 5 year plan
Summary: It emphasizes
Mechanism
Mechanism
Mechanism
NIH 5 year plan
Not so much that it works…
Show me how it works
NIH 5 year plan insufficiencies
In absence of scientific explanatory model noneof the treatments will be accepted by themedical elite
– Especially if it comes from outside the elite sphereof influence
– “we must understand or at least be able explainhow something works if we are going want thegreater healthcare system to accept it.”
Cost effectiveness – virtually absent
Practice based research – nonexistent
NIH 5 year plan insufficiencies
Systems reconciling complimentary and
conventional diagnosis do not exist – (acc. ToDr. Eisenberg)
However,
Donald Kendall has rediscovered basicOriental Medicine perspectives that allude toand link them to the standard world bodyknowledge of pathopysiological diagnosis.
“We are stuck in our tribal robes
without any written truce”
“We need people that are utterly comfortable inthe others domain.”
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otus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: [email protected]
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A look at Roots
Spire
A look at Roots
气 Qì
Cosmological Anatomical Order
Tai Yin = Moon(variable )
Shao Yin = Planets
(variable)
Jue Yin = The Spacebetween
(That whichsurrounds us;
the “gestalt”)
Yang Ming = Brightness(Morning Sunshine)
Tai Yang = Sun
(Hottest in the afternoon)
Shao Yang = Stars
(All around, shining atnight)
Anatomical CorrelationsYang = Lateral
Anterior Lateral Hand =
– Hand Yang Ming (LI) = ALH
Anterior Lateral Foot
– Foot Yang Ming (St) = ALF
Posterior Lateral Hand
– Hand Tai Yang (SI) = PLH
Posterior Lateral Foot
– Foot Tai Yang (UB) = PLF
Lateral Hand
– Hand Shao Yang (SJ/IM)=LH
Lateral Foot
– Foot Shao Yang (GB) = LF
Anatomical CorrelationsYin = Medial
Anterior Medial Hand
– Hand Tai Yin (Lu) = AMH
Anterior Medial Foot
– Foot Tai Yin (Sp) = AMF
Posterior Medial Hand
– Hand Shao Yin (Ht) = PMH
Posterior Medial Foot
– Foot Shao Yin (Kd) = PMF
Medial Hand
– Hand Jue Yin (PC) = MH
Medial Foot
– Foot Jue Yin (LR) = MF
Anatomical Correlations
(Lu) = AMH
(Sp) = AMF (Ht) = PMH
(Kd) = PMF
(PC) = MH
(LR) = MF
(LI) = ALH
(St) = ALF (SI) = PLH
(UB) = PLF
(SJ/IM)=LH
(GB) = LF
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otus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: [email protected]
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Chinese Arteries
FrenchMeridians
ChineseVeins
FrenchMeridians
AMH 1 to 11 Vs LU 1 to 11 ALH 1 to 20 Vs LI 1 to 20
ALF 1 to 45 Vs ST 1 to 45 AMF 1 to 21 Vs PN/SP 1 to 21
PMH 1 to 9 Vs HT 1 to 9 PLH 1 to 19 Vs SI 1 to 19
PLF 1 to 67 Vs BL 1 to 67 PMF 1 to 27 Vs KD 1 to 27
MH 1 to 9 Vs PC 1 to 9 LH 1 to 23 Vs IM1 1 to 23
LF 1 to 44 Vs GB 1 to 44 MF 1 to 14 Vs 1 to 14
Chinese anatomical division nomenclature for neurovascular
nodes (acupoints) versus Soulié de Morant’s usage
1. Internal Membrane System (sānjiāo三焦)
Internal Membrane (IM) System(San Jiao and Pericardium)
Dissection realities
Fu organ concepts
San Jiao functions
Internal membrane physiological features
Longitudinal Importance ( 经
)
Ancient Chinese system of vesselorganization based onlongitudinal distributions
Arteries and Veins identifiedand related to anatomicallocations, internal organs,muscles, referred pain patterns,and cutaneous nervedistributions
Longitudinal View of Body
Chinese observed longitudinal organization andsegmental influence on body
Major blood vessels, muscles, nerves, andpropagated sensation distribute longitudinally upand down body
Organ referred pain, somatovisceral relationships,and neurovascular nodes (acupoints)somatotopically organized
Provides systematic means to stimulate body toprovoke restorative processes
Treatment Approaches
Needling follows simple guidelines
– L A P D Local somato-somato
Adjacent somato-somato
Proximal Segmental innervation
Distal Somato-somato and somatovisceral /
Proprioceptive / Lonigitudinal organization
Visceral
Relationships
Recognized in terms of organ referred pain reflecting
in certain body regions
Also produce organ traction as noted during surgery
Viscerovisceral relationships occur as well where
function or treatment stimulation of one organ
produces autonomic reflexes in another organ
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otus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: [email protected]
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Uniqueness of Organization J ī ngluò经络
The grouping oflongitudinal (up &
down) vessels withrelated nerves,muscles and skinregions enabledneedling therapy toeffect distant parts ofthe body.
(proprioceptivenervous system)
Chinese Vessel Circulation
Chinese medicine theorydescribes the organizationof the blood vessels.
Early practitioners
described the dividing ofvessels into finer branches
Innervation of smoothmuscle is controlled by theANS
Where there are nerves,
there are blood vessels tosupply them
Needling Therapy
Needling therapy effects
the body first – at thecapillary / cellular level
(Sun Mai)
Second – sensory nervesthat affect the CNS
Chinese Vessel Circulation
(J ī ngluò经络 )
Ji Mai [寄脈]– Singular Vessels
– Chong Mai – Thoroughfare – (Aorta)
– Ren Mai – Conception - (Vena Cava)
– Du Mai – Governing – (Azygos, hemiazygos, ascending lumbar)
Shu Mai – Communication; transporation
Jing Mai – Longitudinal distribution vessels
Luo Mai – Collateral vessels
Sun Mai – fine vessels (arterioles, cappillaries,venules)
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all not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute.
Right
Heart
Left
HeartLungs
InternalOrgans
SunLuo
Shu
Jing
Du RenChong
Jing
JingJing
Sun
Shu
Shu
Shu
ARTERIESVEINSLuo
O2CO2
Blood Circulation Direction
Luo
Luo
To: Lower Extremities and Trunk
To: Head, Neck, Brain, Upper Extremities, and Trunk
Dao of Chinese Medicine, Donald Kendall
© Lotus Institute of Integrative Medicine. Shall not be copied, duplicated, or
distributed in any format or be used for teaching without prior written consent from Lotus Institute.
26272829
30
31
32
3334
35
1234
109
8
7
6
5
12
11
17
18 19
2021
22232425
36
37
38
39
40
13
14
15
16
4142
43
45
44
Facial a.
Anugular a.
Superficial temporal a.
External carotid a.
Brachiocephalictr unk
Internal thoracic a.
Superior and inferior epigastricaa.
External iliac a.
Aorta
Femoral a.
Lateral superior and inferior aa.
Anterior tibial a.
Dorsalispedisa.
Dorsal metatarsal a.
Dorsal digital aa.1, 2
1. Medial aspect of the third toe and lateral side of the secondtoe
Arcuate a.
2. Lateral and medial dorsal digital arteries of the first toe andmedial aspect of the second toe
Celiac trunk
Right
gastric a.
Splenica.
Subclaviana.
Common carotid a.
Zygomaticoorbital a.
Dorsal nasaa.
Superior and inferior labial aa.
Arteri es suppli ngteeth are not shown
Left
gastric a.
Underlying Arteries that Supplythe Stomach Nodal Pathway andInternal Regions
Foot Yang-Ming Vessel (Stomach)
[Anterior Lateral Foot Vessel (ALF)]
© Lotus Institute of Integrative Medicine. Shall not be copied, duplicated, or
distributed in any format or be used for teaching without prior written consent from Lotus Institute.
Upper
Extremities
Head, Face,
Neck and Brain
Right
HeartLungs
Left
Heart
Liver
Stomach,
Spleen,
Pancreas,
Small Int.,
Large Int.
Kidney
Lower
Extremities
Urinary
Bladder
Gallbladder
P e r i p h e r a l V e i n s o f T r u n k
Hepatic v.
P o r t a l V e i n
R e n M a i - V e n a C a v a
External Iliac v.
Femoral v.
Renal v.
C h o n g M a i - A o r t a
Gastric a.
Mesenteric aa.
Inferior
Superior
Splenic a.
Celiac Trunk
P e r i p h e r a l A r t e r i e s o f T r u n k
Subclavian v. Subclavian a.
Common Carotid
and Vertebral aa.
Jugulars and
Vertebral v v.
Gastric v.
Mesenteric v v.
Inferior
Superior
Splenic v.
R. Coronary a. L. Coronary a.
Coronary Sinus
Coronary v v.
Pulm. aa.
External Iliac a.
Femoral a.
Renal a. D u M a i - A s c e n d i n g L u m b a r , A z y g o s & H e m i a z y g o s V e i n s
Pulm. v v.
Bronchial v v. Bronchial aa.
Hepatic a.
Cystic a.
Cystic v.
Vesical aa.Vesical v v.
Common Iliac a.Common Iliac v.
Internal Iliac a.Internal Iliac v.
Brachiocephalic v. Brachiocephalic a.
Dao of Chinese Medicine, Donald Kendall
© Lotus Institute of Integrative Medicine. Shall not be copied, duplicated, or
distributed in any format or be used for teaching without prior written consent from Lotus Institute.
Muscle distributions
© Dao of Chinese Medicine, Donald E. Kendall, Oxford University Press
FootYangming
Stomach
Anterior Lateral
Foot
足
陽
明
© Dao of Chinese Medicine, Donald E. Kendall, Oxford University Press
FootTaiyang
Urinary Bladder
Posterior Lateral
Foot
足
太
陽
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all not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute.
©Daoo ChineseMedicine DonaldE Kendall OxordUniversi t Press
FootShaoyin
KidneyPosterior Medial
Foot
足少陰
© Dao of Chinese Medicine, Donald E. Kendall, Oxford University Press
FootShaoyang
Gallbladder
Mid Lateral
Foot
足
少
陽
Disclaimer
Multimedia images used in this presentation are obtained from various
internet sources. No infringement of copy right is intended in the usageof any multimedia images in this presentation. Any multimedia imagesused are purely for nonprofit, educational purposes by the Instructorand the Lotus Institute of Integrative Medicine. These multimediaimages used are not intended for commercial purposes nor for resale, tocomply with Fair Use Laws for multimedia usage from internet sources.
Pictures have been purposely removed from the handout
More info on the c lassic single herbs mentioned in thisseminar/webinar can be found in the Chinese Medical Herbology and Pharmacology
More info on the classic formulas can be found in the Chinese Herbal Formulas and Applications.
Collection formulas can be found in the Lotus Clinical Manual of Oriental Medicine
All the above texts are available through www.elotus.org
Herbs mentioned in this seminar/webinar, are
available through our sponsor Evergreen Herbs &Medical Supplies. Please contact them for a FREEcatalog and see how they can help your practice.
This webinar is sponsored by:Evergreen Herbs & Medical Supplies
Toll-f ree Tel: 866-473-3697Website: www.evherbs.comEmail: [email protected]
7/17/2019 Dkaraba Neijing Tcmwt Handout
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Evergreen Herbs is not just an Herbal company, we are anenvironmentally friendly, health conscious contributor to the health-
care community at large. Evergreen was founded by Dr. John Chenand Tina Chen, siblings and coauthors of the Chinese MedicalHerbology and Pharmacology, and the Chinese Herbal Formulasand Applications books.
Evergreen is a family business that is run by professionals like youwho care about Chinese medicine. And as a family business, wehave the well-being and satisfaction of our customers at the topof our list. We care about the quality of our herbs, because wecare about our consumers, and have your best interest at heart.Our goal is to support you in improving your clinical skills, andenhancing the well-being of your patients.
To learn more about Evergreen Herbs and our products, please