According to Chinese medicine, the human body is part of the natural universe and shares the characteristics of nature.
The five major pairs of meridians share the nature and energy of the five elements. The liver meridian shares the nature of wood and wind; the heart meridian, fire and heat; the spleen meridian, earth and dampness; the lung meridian, metal and dryness; and the kidney meridian, water and coldness.
Shen and ko cycles explain the relationship of one element to another. The shen cycle describes the generative relationship of the five elements: Wood can generate fire; fire can contribute to earth; earth can provide metal; metal can be melted; and water can help the growth of wood.
The emotions of those elements have the same generative (shen) relationship: Fulfillment (liver) may generate joy (fire); the joy (heart) leads to self-confidence (earth); self-confidence leads to empowerment (metal), which leads to motivation (water); and the motivation may once again give the sense of fulfillment.
The ko cycle describes the degenerative relationship of the five elements: water extinguishes fire; fire melts metal; metal cuts wood; wood punctures earth; and earth blocks water.
Likewise, there is the same degeneration in the emotional aspect of these meridians: Fear (kidney, water) can restrain excitement (heart, fire); excitement can overcome sadness (lung, metal); sadness can repress anger (liver, wood); anger can cover up worry (spleen, earth); and worry can cover up fear.
For example, a crying patient may be covering up underlying anger; anger may manifest as being worried. Fear may be used to control excitement, and thrill-seeking behavior may be used to avoid grieving.
The homeostatic goal of a living system is for the five elements to be in balance. When one element is excessive or deficient, it affects that element’s relationship among other elements.
An excessive wood energy may become rebellious for the control of metal energy and overwhelm earth energy. When liver energy is stagnated with excessive anger and resentment, it can cause symptoms in the lung meridian, such as coughing, wheezing, and grief and affect the spleen meridian, causing symptoms like indigestion, fatigue, and worrying.
When one element is deficient, it may fail to generate and control. For example, if kidney qi is deficient—because of its relationships in the shen and ko cycles—it may cause deficiency in the liver meridian, which can cause poor sleep, vertigo, and depression, and an excess in the heart meridian, giving rise to palpitations, anxiety, and insomnia.
Therefore, clinical symptoms of a particular meridian or element imbalance may be a primary issue of that meridian or element or may be secondary to another meridian or element that is having a downstream effect. An experienced Chinese medicine practitioner has ways of assessing these issues and determining primary and secondary dysfunctions.
According to Chinese medicine theory, meridians have points on the surface of the body that are constantly communicating with the outside environment. These surface points, called acupoints, can be used to manipulate the status of qi via the meridians that reach far inside the body.
In the classic practice of Chinese medicine, the practitioner must evaluate a patient’s qi status in the involved meridians and decide a treatment strategy accordingly. He or she will select and combine acupoints and manipulation techniques to restore the balance. Well-trained practitioners will make systematic inquiry of symptoms and examine signs, including the use of tongue and pulse diagnoses, to perform this evaluation.
In modern times, acupuncture is not always practiced according to the theoretical framework of classical Chinese medicine. Some add electric stimulation with the needles to enhance their efficacy. Others have developed a fixed treatment protocol for every patient with a given condition without diagnosing the qi status and meridians involved.
The inconsistency in how acupuncture is approached and utilized may be partially responsible for the differences among studies. When done according to the principles of Chinese medicine, acupuncture relies heavily on energy evaluation that is dependent on the acupuncturist’s clinical experience and training in conceptual and theoretical foundations of Chinese medicine.
The individualized energy pattern differentiation and customized needling techniques make it difficult to create double-blind studies and standardized experimental protocols.
Dr. Yang is a board-certified psychiatrist, licensed acupuncturist, and a fourth-generation doctor of Chinese medicine. His Web site is taoinstitute.com