Five-Phases Acupuncture

 Constitution and Illness

Introduction

In Chinese Medicine, we often hear of the Branches and Roots.  In order to treat an illness the branches should not be confused with the roots.  The branches are the external and most accessible manifestations of an illness while the roots are its most hidden and subtle manifestations.  Added to this notion is the notion of the inherent quality or constitution of a human being.  An analogical example of this notion is found in astrological divisions.  A person born in a specific period of the year may be a Taurus.  Being a Taurus classifies this person into specific sets of characteristics.  He or she may have a tendency to have a weak respiratory system, be prone to anger, have strong financial abilities, and so forth.  Taking into account the date, time and place of the birth, an astrological theme of who the person is, inherently and where the person goes can be established. 

Chinese Medicine offers a similar system of analyzing the person.  This system allows the determination of the intrinsic qualities, strength and weakness, of the individual.  This enables the therapist to formulate powerful diagnostics and predictional management of the patient.

The concept of classification of human beings into categories is not only present into Chinese medicine.  Actually classifying human beings seems to be inherent to both Western and Eastern cultures. 

To name a few, In the West, we find the four qualities as developed in Classical Greece (Air, Earth, Fire and Water) and carried through the medieval mystiques.  Later on, we have the archetypal system started by Carl Jung.  In India, we find the three Gunas (Sattva, Raja and Tama).

Originating from the Chinese systems, at least three classifications exist.  Among others, there is a “base five” system, a “base six” system and a “base twenty-five” system.  The base twenty-five system is mentioned in the Su Wen and used in mainland China.  It is complex and only mentioned for the curious reader.   The base six system is constituted of the six energetic layers (Tai Yin, Shao Yin, Jue Yin, Shao Yang, Yang Ming and Tai Yang).  This system of classification is widely used in the French lineage schools.  Within this system, each energetic group has correspondences at the various human levels (physical, emotional and spiritual).  The base-five system is used in Japanese styles and in the “Five Elements” style of Worsley lineage.  This system is based on the Pentacoordination, “Five Elements” or “Five Phases” diagram.

The Worsley lineage uses the denomination of C.F. or Constitutive Factor to designate the inherent disposition of an individual.  The notion of C.F. may appear obscure and explanations about it are sometimes vague and obscure themselves.

The understanding of the C.F. is paramount to any “Five Elements” practitioner since the entire style is based upon it.

Before trying to define C.F. or any other Constitutive Determination of an individual, we must start from simple notions of what a living being is.  Basically a living being is an organized energetic structure where dynamic relations occur.

The organization is a triad; there is an Energetic organization, a structural organization and an inter-relationship organization.  The “base five” system of classification actually addresses the inter-relationship organization, the “base six” system addresses either the energetic or the structural organization. 

This distinction could resolve the apparent contradiction between a system saying that a person is a Jue Yin-Liver and a system saying that this same person is a Wood-Liver.  The systems are not operating on the same basis, they are complementary, this person is actually Wood-Liver on an inter-relationship point of view while Jue Yin-Liver on a structural or energetic point of view. 

The Worsley system is interesting in that it allows the determination of the Elemental C.F. both from an intellectual approach by using an arsenal of psychological tools and from a purely sensorial approach where the C.F. can be found by the use of the determination of the Color, Sound, Odor and Emotion as purest emanations of the living being.

The following few statements describe the notion of C.F. as perceived by “Five Elements” practitioners:

The C.F. is the Causative Factor around which the human being evolves.
The C.F. is the Central Focus.  It is the place where the practitioner centralizes his or her therapeutic focus.
It is the Elemental Place where all pulses change after the treatment.
It is the Place of strength and weakness.
It is the Place within which the person dwells.
It is heritage and family tendency (origin).
It is the Essence of the person.
It is determined through Sound, Odor and Emotion.

According to one 5E-practitioners, the aim of the construction of the C.F. is for therapeutic intervention into Qi as the sum of:

1. The Jings (Heavens)

Prenatal Jing : 
Ancestral Chi (Genetic)  or Jing
Postnatal Jing:
• Food Chi (diet)               or Gu
• Heaven Chi (breath)  or Tien

2. Emotions (internal)

3. Pernicious influences (external)

4. “Self-narrative” (J. Daniel's opinion).

Through the determination of the C.F., the practitioner “co-manages all aspects and dimensions of the luminous egg that is the other.” J. Daniel

Another dimension of the C.F. is actually the integration of the human being as a component of Heaven and Earth.  Gene Dotson says that “the CF changes when changing location, if you are in tune.”  

This reflects the subtlety of the determination of the C.F.  Only the rigorous training of the practitioner at all levels can lead him or her to the deepest understanding of the most intimate and inherent level of who the patient is.  And from this determination starts the healing.

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Introduction to the Five Movements

The Pentacoordination

0. Introduction

Wu Shu has been translated in a variety of ways, depending on the schools and contexts.  It is used under the various names of Five Movements, Five Phases, Five Elements and Five Transformations.  Finally, it is also used under the name of Pentacoordination in the field of Energetics.

The Pentacoordination is paramount in Chinese medicine and its applications basically extend to all aspects of life, from universal concepts such as astronomy to daily usage such as food preparation.

1. Presentation

The Pentacoordination is a circular graph, oriented clockwise, in the direction of the sun movement.  It is composed of five conceptual objects named Water, Wood, Fire, Earth and Metal.

By placing the Earth in the Center of a system based on the four cardinal directions, we obtain one and only one distribution:

Wood in the East, Fire in the South, Earth in the Center, Metal in the West and Water in the North.

This distribution, demonstrated by the laws of Energetics is rearranged without explanations by the classical sources into a pentagrammatic figure where the Center is placed between the South and West.  This rearrangement is also explained by the laws of Energetics and is the Five Movements Graph as it is generally known.

2. Conceptual Objects

The Five Conceptual Objects, or phases, have a wide variety of correspondences.  Some of the important ones are the cardinal coordinates and seasons.

More subtle are the correspondences with the twelve “meridians” where each phase represents two energetic cores more commonly expressed by two meridians, except for Fire which includes four.

This distribution is again not aleatory, although it is given as postulates by the Classics.  Each phase comprise a Yin and a Yang aspect thus a Yin and Yang core and meridian.

Each phase is under the control of one of these energetic core, which can be named “Operator” of the phase.

Following the classics, we have:

Jue Yin-East, Shao Yin-South, Tai-Yin-Center, Yang-Ming-West and Tai Yang-North.

The second value in the Phase is a joined value.  To these ten values are added in the South the two values Arm Jue Yin (Master of the Heart) and Arm Tai Yin (Triple Heater).

Altogether, we have twelve values allocated as follow:

3. Inter-relationships

The five conceptual objects are not a static structure. 

The main characteristic of this framework is about dynamic relationships between these objects.

These relationships are represented by the name itself of “phases” or “movements.”  In this sense, the name of “Elements” is actually miss-representing the inner concept of the structure.  The structure is motion, life.  It represents the being in action, life in movement.

It is a representation of the continuous integration, responses,. Evolution of a living-being.

Three sets of integrated and intricate systems of relationships characterize this system.  Yet, as intricate as they are, they are distinct and separated.  The texts do not clearly explain their individuality, their inner characteristic.  They basically describe these two movements without going into the details of their beings.  This does not mean that these descriptions are incomplete.  On the contrary, as we will see with the functions of the points, it is quite complex and extended.

The three relationships are respectively the coupled relation, the “sheng” cycle and the “ko” cycle.

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Inter-Relationships in the Five Phases

1. First System

1. Homeostasis within an Element

Each Element is constituted by two systems in inter-regulation.

Within this system, in the Water Element, Shao Yin Kidney and Tai Yang Bladder harmonize one another.

2. Generation Cycle

This cycle is also known as the “Sheng” cycle or Law of mother/child.  It is a circular cycle following a clockwise movement where each Element generates the following one.

3. The Controlling Cycle

The controlling cycle is also know as the Ko Cycle.  It is a cycle of regulation or “mutual checking.”

It is a linear cycle characterized by a clockwise movement where each Element regulates the Element subsequent to the one following it.  A fundamental aspect of this law is the notion of triplet as the basic unit of the regulation cycle logically includes three groups. 

For example, Water regulates Fire and Fire regulates Metal.

According to J. Daniel, It is not a Qi movement.  It is like a web of electromagnetic forces holding everything in harmony and working with the Sheng cycle.

4. Particular Case: The Violation Sequences

4.1 Definition

When the energy becomes deficient or excess in a given Element, the energetic quality of this Element is over-excess by the qualities of the Elements through the Ko cycle or over-deficient by the qualities of the Elements through the Ko cycle.

Under these conditions, the Ko cycle degenerates to become “accroachment” (ch'eng cycle), and the given Element is “violated” (wu) in accordance with a pathological sequence III (reverse Ko cycle)

I.e.: If Wood is deficient, its qualities will be accroached upon (ch'eng) by Metal normally checking it (Ko); and it will be violated (wu) by Earth, which it normally keeps checked (Ko).

An Element does not control its grandchild appropriately (through the Ko cycle), and the latter one violates (insults) the grandparent.

It takes a long time before occurring.

4.2. Example One: Fire violates Water

• Symptomatology: Deficient Qi, Excess heat.  Dry eyes, thirst (Fluids patterns). Late afternoon fever. Sleep problems.
• The tongue is Dry with red tip and scalloped sides.  The tongue coating could be stripped away (when very sever) and it is heavy dry coat on Water zone.
• Treatment:
  • Drink body-temperature water and avoid diuretics (coffee, alcohol, . . .)
  • Transfers or Disperse Fire and Tonify Water
• Comments:
  • When the condition has been treated, the Water will need to be addressed (prevention and consolidation).
  • Generally the violation sequence is long to settle in, so treatments may also take time.

   

4.3. Example Two: Tai-Yin-Spleen violates Jue Yin-Liver

Symptomatology:  a)  Tai Yin-Spleen and Jue Yin-Liver are about Xue-Blood (smooth movement and transport)
There is Stagnation (accumulation, “densification”) leading to Congealed Blood.  The Energy is clogged up.  There is fixed, stabbed pain, heavy menstrual flow, with clots and pain when discharge and hemorrhoids, or varicosis veins (stagnation).

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2. Second System: Five Phases in their Stem Aspect

1. Introduction.

The System of the Five Phases is already a complex system leading to a wider range of both pathological conditions as well as treatment possibilities.

But the Living Being is far more complex to be represented by the Five Phases alone.  Other systems exist, integrating the Five Phases within a wider conceptual picture including for example both pre- and post-heaven trigrammatic sequences.  This lead to a dynamic of the human being based on three graphs.  This system is expounded in the various works of Dr. Mussat and the graphs are reproduced below for sake of illustration.

The Living Being is also incorporated as being “between Heaven and Earth.”  Now, within Heaven, Man and Earth, lays the system of Celestial Stems and Terrestrial Branches that also describe the living being but in a wider context.   A brief overview of some of this system is presented in the next chapter.  Here we will confine to the description of the Generating and Controlling cycles as their relate to the Stems.

2. Generating Cycle

The generating cycle of the Ten Stems shows two sub-cycles:

The yang aspects of the Elements generates each other.
The yin aspects of the Elements generates each other.

Thus;

Yin Wood generates Yin Fire.
Yang Wood generates Yang Fire.

3. Controlling Cycle

The controlling cycle of the Ten Stems shows two bi-directional regulations systems.

Within each Element, the yin and yang aspects regulate one another.
The Yin aspect of each Element is in relation with the Yang aspect of the Element antedating the preceding element.

The Yang aspect of each Element is in relation with the Yin aspect of the Element subsequent to the following Element.

Thus;

Yin and Yang Wood mutually regulate.

Yin Wood and Yang Metal mutually regulate, Yang Wood and Yin Earth mutually regulate.

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3. Introduction to Invasion Processes[1]

It is important to understand that the living being is the result of three evolutive components, Energy, Structure and Functional Inter-relationships.  An invasion can propagate at any of these levels. 

It can follow the linear organization of the meridians or “Structure.”

It can follow the dynamic relations or “Energy.”

And it can follow the functional inter-relationships or “mechanisms” or “Five Phases.”

As much as the invasion processes have been described in the Su Wen, the most beautiful early example of the subtlety of the analytical process of its mechanisms is found in the Shang Han Lu or Treatise of Diseases Caused by Cold.  This work, written by Zhang Zhong Jin some 1,700 years ago provides an insight in diagnostic procedures that may be missed otherwise by contemporary non-Asian acupuncturists.  It is my belief that it should be, as it is in the Traditional Chinese Medical Universities, a mandatory reading for any student.

The referential of study presented here is the Five Phases; we will thus limit the topic to an introduction to the ways invasions may occur in this system.

1. Passage Operator-Joint

Any disturbance of an Operator can directly transmit to its conjoint. 

The inter-meridian evolution (Structure) and the “Transformation”

relationship (Energy) are found back.

According to the traditional rules, two cases exist:

• The passage is from Yin to Yang.  There is relative “aggravation.”
• The passage is from Yang to Yin.  There is relative “improvement.”

As a whole, this kind of disturbance is relatively not important.

2. Circular Transmission

A disturbance in one Element transmits to the following Element. 

Two cases may present;

The disturbance is in the Yang aspect of the Element:

It can propagate to the Yang aspect of the following Element.  The illness stays in the Yang.
It can propagate to the Yin aspect of the following Element.  The illness goes into the Yin, there is “aggravation.”

The disturbance is in the Yin aspect of the Element:

It can propagate to the Yin aspect of the following Element.  The illness stays in the Yin.
It can propagate to the Yang aspect of the following Element.  The illness goes into the Yang, there may be “amelioration.”

3. Pentasymmetrical Transmission

3.1 Bipolar Transmission:

Again two cases are present, each divided into two subcases:

The Element is in excess.  One of the values of the controlled Element is “over-regulated” and becomes relatively deficient.
For example, Excess Yang Ming West leads to Deficient Jue Yin East or Deficient Shao Yang East.
The Element is in deficiency.  One of the two values of the controlled Element is “under-regulated” and becomes relatively excessive.
For example, DeficientTai Yin Center leads to Excess Shao Yin North or Excess Tai Yang North.

3.2. Triangular Transmission.

This case is an extension of the preceding one.

The Excess Element over-regulates the controlled Element, which in turn under-regulates its controlled Element.  This one becomes relative Excess (relatively hyperactive).
The Deficient Element under-regulates the controlled Element, which in turn over-regulates its controlled Element.  This last one becomes relative Deficient (relatively hypoactive).

In the case of triangular transmission, the medial Element plays a role of arrest.  It controls the eventual propagation of the illness.

4. Root of the problem

In case of an illness manifesting at the level of various Elements, it is thus important to determine the origin, medial and target value of propagation.

5.  Conclusion

All the cases of propagation can actually combine to form an intricate scheme.

Strictly remaining at the level of the Five phases, and from a purely mathematical point of view,

Seven possibilities of propagation exist, starting from the Operator or joined value of one Element.

47 possibilities exist for the involvement of two Elements.

329 possibilities exist for the involvement of three Elements.

However the analytic is incomplete, thus false, because it does not take in account the following facts:

The disturbance can also propagate from this path to the Structural or Energetic path, following their own possibilities.
The Energetics of the Elements is a function of time cycles within which the Energy ebbs and flows in each Element. 
There are thus time of greatest strength and greatest weakness for each Element.
Each living being presents an inherent configuration (as the C.F.) thus intrinsic strength and weaknesses.

It is easy to understand the difficulty of diagnosing and the impossibility to grasp acupuncture, even in its most basic terms, in a short period of time.