axis of efficacy part 2 (charles chace)

7/28/2019 Axis of Efficacy Part 2 (Charles Chace)

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. [5]The subtleties o needling lie in its speed.According to Ling Shu-3.1, That the subtletieso needling lie in its speed, means slow or ast[needle manipulation]. 45

I it is the crude who attend to the mechanicso needle technique, then how is it that thesubtleties o needling lie in its speed? Thisis a relative statement, predicated upon thesensibilities established in the rst our lines. It

a. .

The Ling Shu Prcis from chapter one of the Ling Shu

Please tell me of the way [of needling].The essentials of the small needle areeasy to explain but difficult to engage.The crude attend to the form, thesuperior attend to the spirit.Spirit oh spirit! There is a guest at thedoor.Without observing the disease, howcan one know its origin?The subtleties of needling lie in itsspeed.

The crude attend to the junctures andthe superior attend to the dynamic.The movement in the dynamic is notseparate from its empty spaces;The dynamic within this empty spaceis clear, still and subtle.Its coming cannot be met and itsgoing cannot be pursued.Those who understand the way of thedynamic, will not impede it and thus itmanifests.

Not understanding the way of thedynamic, one detains it and thus itfails to show itself.To understand its goings and comings,emphasise its periodicity.The crude are in the dark about this;sublime! Only practitioners have it.Going away from it is contrary,promoting its arrival is goingwith the flow.If one clearly understands the contraryand normal [flow of qi], then you canact correctly and without doubt orquestion.By meeting it and taking it away, howcould one not achieve depletion [of the qi]?By pursuing and assisting it, howcould one not achieve repletion [of the qi]?Whether meeting it or following it,by means of ones attention, oneharmonises it.

This is all there is to say with regard tothe way of needling.

An axis o e fcacy

The range o meaning inthe Ling Shuchapter one

By Charles Chace & Dan Bensky

In the last issue, authors Charles Chace and Dan Bensky began adiscussion o the frst section o Chapter 1 o the Ling Shu. In thesecond part o this article, they continue the translation o this sec-tion, which they call the Ling Shu Prcis. They also urther explorethe subtle concept o ji in this text, which suggests that the me-chanics o needling, while important, are secondary to the mannerand intention with which they are engaged by the practitioner.


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is not that technique is unimportant, onlythat it is useless without the proper leveland quality o attention.

The rst ve lines establish that the

superior way to practice is to develop arelationship with spirit that is played outthrough ones engagement with the patientsqi, blood and corporeal orm, and is alsoexpressed in ones application o needletechnique. The text now presents a newdichotomy, one that echoes the ormulationdescribed in Line 2 that the crude attend tothe orm, the superior attend to the spirit.

. [6]The crude ttend to the junctures ndthe superior ttend to the dyn mic.This line is the crux o the passage. LingShu-3.1 explains:

That the crude attend to the junctures meansthat they attend to the our extremitiesand do not understand the departureand arrival o the correct and pathogenic[in uences] within the qi and blood. Thatthe superior attend to the dynamic meansthat they know how to attend to the qi. b46

Zhang Jie-Bin comments on this line inhis Lei Jing ( Classi ed Classic, 1624)saying: That the superior protect thedynamic, means that one must examine themovement and quiescence o the arrival o qi. c47 For Zhang, ji is primarily a refectiono the activity o the qi. At this point inthe discussion, the state o the correct orpathogenic qi, its excess or de ciency issecondary to a more general appreciationo the qis comings and goings, a mode o

perception that is de ned by the ocusedconcentration o the spirit within onessel . One attends to the ji by means o onesspirit and ones attention.

It is no accident that the superiorpractitioner attends both to the spirit andto the dynamic. As already discussed, theyare two sides o the same coin. The dynamicis the way the spirit expresses itsel and theway to truly engage the spirit is through thedynamic. The two words are closely linkedin the Nei Jing. When they appear together,

b..

c. .

they re er to the overall li e activity.d48 According to Su Wen-70, What is at thecentre, is called the spirit-dynamic; i thespirit departs then the dynamic ceases. e49

Zhang Jie-Bin explains this as: What isat the centre o things takes the spirit asprimary, and ones conscious activity isthe expression o the spirit-dynamic. Forthis reason, i the spirit departs, then thedynamic also ollows and ceases.. 50

One might equally say that the superiorattend to the situation or disposition (shi ).As Zhang Jie-Bin points out, this is not astatic state o a airs, but a fuid ebb andfow o circumstance that is played out inthe qi. The job o the physician is to discernthe precise moment, place and manner tointervene. Perhaps the most importantcharacteristic o this intervention is thatit too, will issue rom the spaces betweenphases o activity, a place o stillness.

. [7]The movement in the dyn mic is notsep r te rom its empty sp ces; thedyn mic within this empty sp ce iscle r, still nd subtle.

Ling Shu-3.1 continues its interpretivethread in reading this line both as asimple statement o ones understandingo de ciency and excess, while alsoacknowledging the deeper thread that thequality o ones intention is pivotal to thee cacy o ones needling.

That the movement in the dynamic is notseparate rom its empty spaces means thatone understands the state o defciencyor excess within the qi, and the speed

with which to wield the needle. That thedynamic within this empty space is clear,still and subtle means that when needlingto obtain the qi one must be extremely ocused, attending to the qi so as not tolose it.g51

Zhang Jie-Bin endorses the interpretationo the second passage. This means thatone must examine [the patient] withd.e. .

.

g..

It is not that technique isunimportant, only thatit is useless without the proper level and quality o attention.


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detail and circumspection. h52 The moderncommentator Guo Tian similarlyemphasises the state o mind essential to acare ul examination. The physician must

maintain a high degree o concentrationand quietude. i53

The dyn mic is de ned by sp ce ndemptinessThe crux issue, however, as the next linemakes clear, is that the ji is de ned by thespace or emptiness around which all thisactivity hinges. It is the axis o quiescence rom which activity springs. This is thereason why one must quiet onesel in orderto perceive it. On one hand, ji is the overallstate o the qi and blood, and relative balanceo healthy and pathogenic qi. As such, it isthe disposition or propensity (shi ) o the situation. An appreciation o the initialpropensity o a situation allows one to acte ectively. O equal importance, it allowsone to intervene at the beginning o thingswhen they are still nascent or incipient (ji

) so that it appears to be e ortless (wuwei ).54

Then again, ji resides in the spaces between

activity. It is the quiescence between phaseso activity, and it is rom here that onesintervention must be based. On anotherlevel, ji is the incipient point o stillness

rom which health arises and it is the jobo the physician to discover that withinthe patient. Even the most materialisticcommentaries acknowledge that because ji resides in empty spaces, its engagementrequires a certain kind o attention. 55 There ore, physicians must themselves beclear, quiet and ocused to competently

assess the stillness o the dynamic thatalso expresses itsel in the empty spaceswithin the matrix o qi. Such a perspectiveencompasses the viewpoints o existingcommentaries, even as it lends continuityto the entire passage.

. [8]Its coming c nnot be met, nd its goingc nnot be pursued.Line 8 is another pivotal line in theinterpretation o this text. Ling Shu-3.1reads the line as an expression o the well-h. .i. .

known axiom that one must not drain ade ciency or supplement an excess. Thatits arrival cannot be met means that theqi is brimming and cannot be toni ed j

and that its departure cannot be pursuedmeans that the qi is de cient and cannot bedrained. 56

There is some debate as to just whatkind o qi is being re erred to here. ZhangZhi-Cong interprets the unspoken topic o Line 8 to be speci cally pathogenic qi. I this qi has just arrived, then the pathogenicqi will become properly exuberant. I thepathogenic qi is exuberant then the correctqi is greatly de cient. I one cannot availonesel o the qis arrival then one shouldmeet and toni y it. l 57

Line 8 introduces another aspect o jirelating to the timing o ones intervention.

It is, o course, ill-advised to toni y excessesand drain de ciencies, but the mannerand timing with which one acts is equallyimportant. This emphasis is apparent inthe explanation provided in Su Wen-27.3.

I one awaits the pathogenic qi and does notexamine it until the great [pathogenic] qi

has already passed, and then drains it, thetrue qi will collapse. I it collapses, it willnot recover. The pathogenic qi will returnagain and the disease will worsen. This iswhy its going cannot be pursued.m58

Zhang Zhi-Cong also stresses onesawareness o the the subtleties o bothcoming and going.

One cannot avail ones sel o the [correct] qisdeparture, but [still] pursues and drains

it, the concern is that one may damage[the patients] correct qi. The crux is inthe subtleties o its nascent coming and going.n59

Ji lies in the spaces o quiescence betweenthings which in this context are the comingsand goings o the qi. When one works rom

j. .k. .l. .

, .m. ,

.n. ,

.

It is, o course, ill-advised to toni y excesses and drain defciencies, but themanner and timing withwhich one acts is equallyimportant.


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the ji and ones action becomes e ortless(wu wei ) and even the most subtleinfuence has a signi cant impact. Onceagain, the state o ones mind or spirit is

a crucial part o the equation. Accordingto Zhang Zhi-Cong, [one must] calmlyattend to the intervals between the comingsand goings [o the dynamic] and toni y ordrain it. Even the slightest error o a hairsbreadth and it will be lost! o 60

Ones attention to the periodicity o theqi and its relation to the dynamic is animportant thread in the Ling Shu Prcis thatis reiterated in Line 11. Be ore one can hopeto execute any needle technique one mustattune onesel with the timing o the qiitsel . One must neither go rushing to meet,nor chasing a ter the qi, but remain insteadwith the dynamic . The superior practitionerexecutes the techniques o toni cation anddrainage rom the within the empty spacesbetween the comings and goings o the qiin a calm and ocused state o mind. Theidea is to stay out o the way o the healthy

unctioning o the qi. This principle is thenstated explicitly in the ollowing line.

, . [9]Those who underst nd the w y o thedyn mic, will not impede it nd thus itm ni ests. 61 Ling Shu-3.1 states: That one cannot impedeit and thus it mani ests means that the qi iseasily lost. p62 Subsequent commentatorslink the ji, the subtle interval between thecomings and goings o the qi to the goal o its overall uni cation. Ma Shi, in particular,emphasises the single-pointed nature o ji. For those who know the way o the

dynamic, there is only this uni ying qi, andit is as i it cannot be impeded by so muchas the space o a single hairs breadth. 63 In interacting with it, one must match thesubtlety o the dynamic as the incipientinitiator o activity.

, .64 [10]Not underst nding the w y o thedyn mic, one det ins it nd it thus ilsto show itsel .Those who comprehend the dynamic do

o. .p. .q. .

not impede it. By impeding the dynamic itails to mani est itsel . I the dynamic, and

consequently the qi, ails to mani est itsel ,one cannot even begin to comprehend the

intricacies o toni cation and drainage.This is the central message o the Ling Shu-3 commentary. One detains it, and thus it

ails to show itsel , means that one has noknowledge o the meaning o toni cationand drainage. Once the qi and bloodare exhausted, the qi cannot be directeddownward. r65 This is what happens whenone is too aggressive in ones intervention,or even ones intention.

By perturbing the dynamic, one createsun avourable circumstances or itsexpression. How does one allow the dynamic to express itsel ? The ollowing line explainsthe way in which one must attend to theintervals o its comings and goings.

, . [11]To underst nd its goings nd comings,emph sise its periodicity.This and the next our lines concern theconcept o goings and comings ( wanglai ) that de ne the qi dynamic and

its relationship to meeting and ollowing( ying sui ). Ling Shu-3.1 picks up itsinterpretive thread reading Line 11 interms o fow and counterfow, excess andde ciency. To understand its goings andcomings means that one knows the qisstates o contrary and normal [movement]and whether it is brimming or de cient. s66 Yet even this text acknowledges that suchconsiderations are dependent on onesattunement to the periodicity o the qi.One who emphasises its periodicity knows

the opportune moment when the qi can betaken. t67

Zhang Jie-Bin emphasises proper timingin accordance with the comings andgoings o the qi even as he articulates themechanical details o toni cation anddrainage techniques. One should toni yand one should drain according to theopportune moment in the instant whenone meets the qi. u68

r..

s. .t. .u. .

One must neither gorushing to meet, nor chasing a ter the qi, butremain instead with thedynamic.


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Ling Shu-8.2 directly links ones attunementto ji to various aspects o the spirit. What

ollows the coming and going o the spiritis called the ethereal soul and essence.

That which goes out and in together withthe essence is called the corporeal soul . v69 Such a reading broadens the scope possiblemeanings considerably.

The topic o line 8.2 is still the ji. There isno question that the goings and comings o the qi are nothing more than an expression o ji, which is what Isabelle Robinet describesas the dynamic aspect o the Way. 70 TheNei Ye ( Inner Workings) chapter o theGuanzi ( Guanzi, 26 BCE), an early texto Chinese mysticism, describes the goingsand comings o the Way in terms thatpresage the language used in the Ling ShuPrcis and elsewhere in the Nei Jing.71

Where the Nei Yeasserts, The way is whatlls the body, yet people are unable to x it

in place. It goes orth but does not return. Itcomes back but does not stay. w72 Su Wen-15 echoes this sentiment in asserting that,the spirit changes and does not revert, i it reverts it cannot change, and so loses its ji. 73 The expression o ji is necessarily in a

constant state o fux even as it remains stillwithin itsel .The Nei Yerepeatedly identi es tranquillity

as a prerequisite or the appearance o thisessential vitality. Moreover, it xes the qiboth within the heart-mind and within thecorporeal body.

There is a spirit naturally residing in the body,,

one moment it goes, the next it comes,,

And no one is able to conceive of it..

If you lose it you are inevitably disordered..

If you attain it you are inevitably well ordered..

Diligently clean out its lodging place,,,

And its vital essence will naturally arrive..74

v. .w.

.x.

That miraculous qi within the mind

One moment it arrives, the next it departs

So fine there is nothing within it,

So vast there is nothing outside it,

We lose it

Because of the harm caused by mental agitation,

When the mind can hold on to tranquillity,,

The way will become naturally stabilised..75

In practising acupuncture, physiciansmust certainly attend to the relativelymechanical goings and comings o the qi,its pacing and its intervals. But it is essentialto remember that this is the most super cialexpression o a much deeper dynamicplaying itsel out in the interaction betweenones patients and onesel .

. ! . [12]

The crude re in the d r boutthis. How sublime! Only [s illed]pr ctitioners h ve it.The topic o this line is the goings andcomings o the qi dynamic that are essentialto e ective needling. Yet in light o thebroader perspective on ji detailed above, itis not surprising that the author o the LingShu-1.1 would consider the principles hehas presented to be sublime. According toLing Shu-3.1, That the crude are in the darkmeans that they are benighted and do not

understand the subtleties o the qi. That it issublime and practitioners alone have it meansthat they have an exhaustive knowledge o the implications o needling. y76 Su Wen-26.2uses remarkably similar language in pointingout that it is not the outward appearancethat one must attend to. Examination bythe benighted means that the circulation o qi, nutritive, and de ensive is not mani estedexternally and [superior] practitioners aloneknow it. 77

Up to this point the Ling Shu Prcis

y..

. .

The Nei Ye repeatedlyidentifes tranquillityas a prerequisite or the appearance o thisessential vitality. Moreover,it fxes the qi both withinthe heart-mind and withinthe corporeal body.


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has established that one must attendto the ji by means o the spirit. The ji ischaracterised as an empty space and as aplace o quiescence between the intervals

o activity. Attention to these intervals is thekey to an e ective needle technique. Theseare the true essentials o needling. Here thetwo interpretive threads begin to merge.The ocus o the discussion now shi ts toaddress more speci cally the way in whichone should interact with the movementaspect o the qi.

[13]

Going w y rom it is contr ry,promoting its rriv l is going with thefow.Line 13 introduces the opposing conceptso ni andand shun , which are de ned inrelation to the departure and arrival o theqi. Ni here does not necessarily suggest astate o counterfow or a going againstthe normal ( shun ) fow o things. LingShu-3.1 suggests that ni re ers to the normalebbing o the qi as it departs. The qi is niin that it is relatively de cient during thisphase o its cycle. That going away rom

it is contrary, re ers to the qis de ciencyand its railness. To be rail is contrary and promoting its arrival is going with thefow, re ers to a balanced state o the ormqi. Balanced is going with the fow. b78 The emphasis here is that one must act inaccordance with the normal cycles in thefow o qi.

, . [14]I one cle rly underst nds the contr ry

nd norm l [fow o i], then one c n

ct correctly nd without doubt oruestion.

Ones appreciation o the ebb and fow o qi is crucial to e ective needling.Ling Shu-3 makes the interesting point that such anunderstanding in orms ones selection o acupuncture holes, as well as the timingand the needle technique one will use. I one clearly understands the contrary andnormal [fow o qi] one can act correctlyand without errors, means that one knowshow to select the place [ or needling]. c79

aa. .ab. .ac. .

The Ling Shu Prcis goes on to make twomuch more general statements as to howsuch an understanding promotes e ectiveintervention.

, ?[15], ?80 [16]

By meeting it nd t ing it w y, howcould one not chieve depletion [o the

i]?By pursuing nd ssisting it, howcould one not chieve repletion [o the

i]? The descendent texts in the Nei Jing andthe commentary literature are airly clearas to the meaning o these lines. Ling Shu-3.1 succinctly states: Meeting and takingit away is drainage, d and Pursuing andassisting it is toni cation e.81 Only i you

ollow and assist the qi, acting as a midwi eto the qi, will you make the qi fourish.

, . [17] Whether meeting it or ollowing it,by me ns o ones ttention, oneh rmonises it.The crux o line 17 is yi , generally

translated as intention, denoting anexpression o volition or purpose ulness thatis closely linked to will (zhi ). The Mencius states: The will is the general o the qi; qi iswhat lls the body. When the will arrives, qi

ollows. Thus it is said; Maintain your willand do no violence to your qi. f 82

Mencius point is that people should begoverned by their will and not their qi,but his statement has resonance or thoseinvolved in medical practice as well. Forsome physicians, intention is the key to

regulating the qi and it is brought intoharmony by the orce o their willpower.This reading o yi works but it is at leastsomewhat at odds with the principles laidout previously in the Prcis.

Be ore yi becomes intention, it is rstan awareness or an attention in the sensealready described above. This use o theword is prominent in the Nei Ye whichasserts the primal nature o yi in nouncertain terms.

ad. .ae. .a .

.

Ones appreciation o the ebb and ow o qi iscrucial to e ective needling.


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That mind within the mind:,

it is an awareness that precedes speech..

Only after there is an awareness does it takeshape;

;Only after it takes shape is there a word.

.Only after there is a word is it implemented;

;Only after it is implemented is there order.

.Without order you will always be chaotic.

.If chaotic, you die.

. 83 Yi is what occurs be ore one thinks in

words. Be ore one orms an intention onerst becomes aware. Prior to exercising

ones intention in needling, one must rstre ne ones attention.

In contrast to Mencius, the author o theNei Yeasserts that qi is not so much governedas it is stabilised, and this is accomplishednot by the orce o ones willpower but by

the stabilisation and attentive awareness o ones consciousness.

Once the qi is attended to and apprehended,,

The sub-celestial realm will submit..

And once the minds attention is stabilised,,

The sub-celestial realm will listen..84

Using language that is remarkably similarto that used in the Ling Shu Prcis, the NeiYe explains that the qi cannot be bent toones will using orce o any kind,

Therefore, as for this qi,,

it cannot be halted by force,,

and yet it can be calmed by virtue,.

It cannot be called by sound,,

but it can be met with attention..85

Ones capacity or e cacy resides in thee ortless activity and infuence o onesconsciousness resides in quiescence.

Relaxed and unwound, yet benevolent,,

In solitude you delight in your own person..

This is called revolving the qi::

Ones attention and actions seem heavenly..86

Finally, the text even outlines the meansby which we attain this tranquillity.

When the four limbs are aligned,,

and the blood and qi are tranquil,,

One may unify ones attention, andconcentrate ones mind.

.One's eyes and ears will not be sullied.

.[To attain this,] though it seems distant, it isclose at hand.

.87

Anyone who has ever practised acupunct-ure will appreciate the truth o thisstatement. Form matters; in the processo needling one cannot be sloppy in onesstructural alignment.

This is an essential means or uni yingones mind, and thereby ones own qi andblood. It allows one to place onesel in theoptimal position to appreciate the ji o thepatient and to act both e ortlessly and

e ciently.For all its subtlety, ji is undamentally

grounded in substance. That may well bewhy subsequent Ling Shu commentatorshave tended to ocus on its mostmaterialistic attributes; they are the easiestto talk about.

Be that as it may, when all is said anddone, regardless o whether one is meetingor ollowing, toni ying or draining, whetherone is working with qi, blood, the channels,or the subtleties o ones needle technique,the harmonisation o the qi depends onones attention to the ji.

Form matters; in the process o needling onecannot be sloppy in onesstructural alignment.


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. [18]This is ll there is to s y with reg rd tothe w y o needling.

Conclusion

The nal line o the Prcis may be takenquite literally. That really is all there is tosay about the art o acupuncture. The resto the Ling Shu is exegesis. The import o this initial passage has less to do with themechanics o excesses and de ciencies,toni cation and drainage than it does withthe undamental sensibility with whichthey must be engaged. This sensibilityis intimately connected to the resonancebetween ones spirit and the dynamic.Whatever else the notion o spirit mayencompass, it most certainly involves

ocused quiescence on the part o thepractitioner. At the core o the concept o ji is a state o quiescence occurring betweenthe comings and goings o qi. Ji is the pivotaround which the qi organises itsel . Byattuning onesel to the ji one can mostpro tably assess and exploit the disposition o a situation. From here, one need do very

little to exert a pro ound infuence, andor this reason, ones intervention becomesvery subtle. Going to meet or ollowinga ter the qi is not a headlong thrust in onedirection or another so much as a nod or awink at just the right moment and in justthe right way. In moving rom the ji, it is notonly the needle that becomes the Ling Shu

, the divine pivot, but the practitioner.

Endnotes

45. Huang Di Nei Jing Ling Shu Jiao Shi , v.1, p.68.

46. ibid.47. Zhang Jie-Bin (1964), p.627.48. Guo Tian, p.433.49. Huang Di Nei Jing Su Wen Jiao Shi

, v.2, p.1008.50. Zhang Jie-Bin, v.2, p.887.51. Huang Di Nei Jing Ling Shu Jiao Shi

, v.1, p.68.

52. Zhang Jie-Bin v.2, p.628.53. Guo Tian, p.433.54. For two excellent discussions o the

concept o shi in Chinese culture, seeFrancois Jullien (1995) and (2004).55. Ma Shi is a holdout who is content tointerpret the empty spaces in very concrete

terms. The Su Wen has a Discourse on theBone Holes (Chapter 60) that indicates thismeans the empty spaces along each channel( , .) Ling ShuZhu Zheng Fa Wei .56. Huang Di Nei Jing Ling Shu Jiao Shi

: v.1, p.68.57. Huang Di Nei Jing Ling Shu Jiao Shi

: v.1, p.3.58. In many editions si is hou . HuangDi Nei Jing Su Wen Jiao Shi

: v.1, p.371.59. Huang Di Nei Jing Ling Shu Jiao Shi

: p.3.60. ibid.61. An alternative translation might be Theway o knowing the dynamic, is that it cannotbe impeded and thus it is expressed.62. Huang Di Nei Jing Ling Shu Jiao Shi

v.1, p.67.63. Ling Shu Zhu Zheng Fa Wei

.

64. Kou is alternately be read as kou to knock. One knocks [on its door] but itdoes not show itsel .65. The implication is that the qi cannotbe directed downward, lest it counterfowupward regardless o the practitionersintention ( Huang Di Nei Jing Ling Shu JiaoShi : v.1, p.68).66. Huang Di Nei Jing Ling Shu Jiao Shi

: v.1, p.68.67. ibid.

68. Zhang Jie-Bin v.2, p.641.69. Huang Di Nei Jing Ling Shu Jiao Shi

: v.1, p.174.70. Robinet (2008): pp.536-37.71. The Nei Ye appears as a chapter inthe Guanzi , however, it is generallyconsidered an independent text in its ownright.72. Translations o the Nei Ye are our own,with re erence to Harold Roth (1999) and W.Allyn Rickett (1998). Guan Zi Zhu Zi Suo Yin

: 16.1/115/26.73. Huang Di Nei Jing Su Wen Jiao Shi

: v.1, p.190.

Going to meet or ollowing a ter the qi isnot a headlong thrust inone direction or another somuch as a nod or a winkat just the right momentand in just the right way.


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axis of efficacy part 2 (charles chace)

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