The Classic of Supporting Life with Acupuncture and Moxibustion Vol. I-III

The Zhēn Jīu Zī Shēng Jīng (The Classic of Supporting Life with Acupuncture and Moxibustion) by Wáng Zhízhòng as translated by Yue Lu (with editing by Lorraine Wilcox) is an absolutely phenomenal resource for the clinical use of acupuncture and moxibustion.

This text stands out amongst many of the Classics for several reasons: the first of which is that Wáng Zhízhòng was a keen researcher, who would not only compare source materials against each other, but also cite which source materials he compared, and how they were the same or different. Secondly, while Wáng was a gatherer of information, he was also practical, and this book is filled with his many many pearls of how he used a point prescription, why and what the results were of his own tests of the material.

Thirdly, to date there is no other classical material which is as complete in subject matter as the Zhēn Jīu Zī Shēng Jīng. Wáng categorized not only the point locations, and how to use the points with what method, but systematically collated 196 disease patterns from the most exterior down to the deepest levels, documenting multiple presentations and treatments for each pattern. Lastly, Wáng's primary focus was on supporting or nourishing life through the use of these techniques, and therefore there are a significant number of these treatments that either use moxibustion as the primary treatment method, or use moxibustion after the primary treatment method. In the modern age, we are extremely lucky to have access to the classical sources for East Asian Medicine, and this is partly because of the hard work of translators like Yue Lu and Lorraine Wilcox.

Wang Zhizhong was a man full of contradictions. On the outside a moderately successful teacher of Confucian learning, in his later years he gained renown instead for his private study and practice of the art of medicine. His text《針灸資生經》Zhenjiu Zisheng Jing contains the results of his studies – page after page devoted to resolving age-old discrepancies in the recorded locations of traditional acupoints, and passage after passage recording his own clinical experience in locating the most effective acupoints for specific patients at the time he treated them. Why then, when his own experiences with patients showed that the exact location of an acupoint could be found through palpation, did he still devote so much effort to recording and standardising the location of named acupoints? This is the question that I brought to this new and exceptionally accessible English translation of the Zhenjiu Zisheng Jing: The Classic of Supporting Life with Acupuncture and Moxibustion (Volumes I to III).

In this day and age, where textbooks feature descriptions of the locations and routes of acupoints and channels as if they were incontrovertible fact, it is easy to assume that these areas and connections have always been agreed upon, and that there is no disagreement among the various authoritative texts. This was by no means assumed to be true by Wang Zhizhong, as can be seen in Volume I. Here he lays out the result of his efforts to reconcile the different standards for acupoint location and cun measurement methods, and sets out a single standard for both. His influence on later generations can be seen when it comes to the location of abdominal points, where his chosen standard of 1.5 cun (measured JJoouurrnnaall ooff CChhiinneessee MMeeddiicciinnee •• NNuummbeerr 110066 •• OOccttoobeerr 22001144 Reviews 57 using the distance between the creases of the middle finger as one cun) between the Kidney, Stomach, and Liver channels on the abdomen was used by texts for the next half-millennium, including such classics as the Zhenjiu Dacheng, (Great Compendium of Acupuncture and Moxibustion). However, Wang Zhizhong made no effort to conceal evidence of any discrepancies between his sources, and in fact took great care to leave behind a record of his thought process and the names of the texts to which he referred. This takes us to Volume II, where in this careful translation written in natural and idiomatic English, we find an unusual treat – more than a dozen of Wang Zhizhong’s personal essays on matters relating to moxibustion, acupuncture, herbs and the art of healing. For example: ‘Qian Jin Yao Fang says: There are old and young people, with tall and short bodies, fat and thin skin. So we need to consider this thoroughly and discuss it, and be precise when locating points. [Points are located] in the muscles, in the cleft of the joints, or in depressions. Patients feel happy when we press these points. If we locate the points carefully, peacefully, and serenely, we can find them [accurately]., (2.08 Locating points)

Such essays are a rarity among medical classics, which tend to be written in more of a distant and authoritative voice. However, as smooth and easy to read as this English translation is, one must still remember that Chinese texts of that time were not meant to be quickly devoured like the latest bestseller in the airport bookstore. As Wang writes, this material is to be ‘… considered thoroughly and discussed.’ These passages lend themselves to being mulled over, deliberated upon and perhaps committed to memory in the same way one might appreciate poetry.

In a text like this that has been passed down for nearly a thousand years, it is rare for the complete text to have found its way to us unharmed. Even though I accept this, I still feel that it is a terrible loss to us that the last three of Wang’s personal essays did not survive. One of the three, titled ‘Zhenjiu Shou Bing Chu’ (‘Areas affected by disease in acupuncture and moxibustion’) might have helped us address the seeming contradiction that runs throughout his writing – the fact that Wang both palpated for areas of soreness to determine where to needle, and at the same time obviously placed great importance on determining the standard body-cun location of acupoints.

In Volume III (as well as the forthcoming Volumes IV-VI) we find another unique aspect of the book: a listing of acupoints by disease with personal commentary. The phrase ‘area affected by disease’, or variations such as ‘[an area that] aches when pressed’, appear in Wang’s clinical commentary several times: ‘We should apply this moxibustion on the bony prominence that aches when pressed’ (Chapter 3.29, Bloody stool), ‘I pressed her Da Chang Shu and she felt sharp pain’ (3.33, Intestinal pain). The use of palpation to precisely locate effective acupoints, or to help determine whether or not to use a documented acupoint, is one of a great many traditional techniques that did not make their way into modern TCM textbooks in China or the West, a situation which has affected the way acupuncture and moxibustion is practised today. The situation in modern China was described by contemporary Chinese medical scholar Wei Jia (魏 稼) as follows: ‘For a long time we have emphasized the clinical application of static points [i.e. acupoints with names and fixed locations], while deep and broad exploration of dynamic points [i.e. acupoints that have no fixed name, location, or number and are often in a hidden or mobile state, requiring special diagnostic techniques to identify] has not elicited enough attention. [Changing this] will improve clinical results, and help to develop or even reconstruct acupuncture theory.’ ('动穴疗效钩玄'魏 稼 中医药通报 2008年 第7卷 第1期). It is exciting to think of the role that the publication of this translation might play in the continuing emergence of this hidden side of the medicine, and the influence it might have on future editions of college textbooks.

I do not feel that in my reading of this text I was able to reconcile the deeper conceptual contradiction between the apparent existence of both static and dynamic points – one existing irrespective of individual or disease, and the other identifiable only in the moment. However, we can find a hint of justification for the efforts Wang took in standardising and recording acupoint locations in heartfelt quotes such as ‘If [he] had burned three or five hundred cones of moxibustion [as recorded in Tong Ren Shu Xue Zhen Jiu Tu Jing], the patient might have lived a long time, too.’ (p.76); or ‘Note that Su Wen – Ci Jin says: The patient will become limp if the patella is punctured and fluid comes out. Du Bi (ST 35) is located below the patella, on the shin bone. The acupuncturist must not disparage this.’ (p.134); and ‘I have saved more than a hundred people already’ (p.271). Lines such as these make it quite clear that Wang Zhizhong recognised the importance of transmitting and passing on the clinical pearls of his predecessors. One might say that Wang accepted that the process of naming and recording the location of acupoints, using the fairly consistent and accurate body-cun method, was the best way possible to pass on knowledge in a textual form – and this was valuable enough in and of itself to justify his efforts.

This English translation, authored by Yue Lu and edited by Lorraine Wilcox, is published complete with the original Chinese, acupoint illustrations and a detailed table of contents and indices. Nearly one millennium after it was first published, in this text we are given access to a lifetime of scholarly and clinical experience in moxibustion, acupuncture and herbs.

 Henry Buchtel