Hello everyone, today I will talk about the collaterals, a topic I have wanted to discuss for a long time. However, I always felt I lacked sufficient clinical experience and feedback, and it seemed incomplete. Before discussing collaterals, let me first talk about the “Shang Han Lun” (Treatise on Cold Damage).
Why discuss the “Shang Han Lun” before talking about collaterals? Think about it, what are the meridians? The pathways through which Qi flows in the body. The “Shang Han Lun” is the earliest book on syndrome differentiation and treatment, laying the foundation for TCM’s approach to diagnosis and treatment. From this perspective, if the meridians were already established during the Huangdi Neijing (Yellow Emperor’s Inner Canon) era, the later texts guide you on how to navigate these pathways, thus holding greater significance. Before entering school, the four great classics, especially the Huangdi Neijing, have been discussed to the point of exhaustion, yet the importance of the “Shang Han Lun” is often overlooked. I believe the “Shang Han Lun” is crucial not just because it is one of the earliest formula books, but because many treat it merely as a formula book, losing its essence. This book is not only a dictionary but also a narrative.
For instance, a patient with insomnia consulted many doctors, and many prescribed Suan Zao Ren (Sour Jujube Seed) as the first herb. When the third doctor was asked if he would also prescribe Suan Zao Ren, the patient replied that it did not work for him. The doctor became angry and asked, “Are you a doctor or am I? The others prescribed Suan Zao Ren ineffectively because the dosage was insufficient.” As a result, the patient experienced acid reflux and insomnia despite taking the herb. Adding one herb for one symptom can be relatively harmless, but some practitioners prescribe multiple formulas for various symptoms, such as adding Xie Xin Tang (Drain the Heart Decoction) for a feeling of fullness, or adding Ge Gen Qin Lian Tang (Pueraria, Scutellaria, and Coptis Decoction) for diarrhea, or Xiao Chai Hu Tang (Minor Bupleurum Decoction) for alternating chills and fever. Eventually, the total dosage becomes excessive. This is akin to the ‘sea battle’ strategy in acupuncture. We lack a complete thought process, which is why it is essential to align with a doctor who shares a similar approach.
For example, in the case of a cough, what is the cause? Wind-cold. What is the location? The lung orifice. What is the mechanism? Lung Qi is not dispersing, and lung function is impaired, etc. We cannot prescribe a formula, or there may be many possible prescriptions. During my university years, I often used a formula combining Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Zhi Sou San (Stop Coughing Powder), which would filter out patients unsuitable for that formula. For a period, I only knew how to use that one formula. I once heard someone explain the “Shang Han Lun” using the game Plants vs. Zombies, where the Sun Meridian represents the outer layer, the exterior syndrome. Once the nuts are consumed, you enter the yard, which represents a half-exterior, half-interior syndrome, treated with Chai Hu formulas. Moving further inside leads to the house, which corresponds to the three Yin meridians. The bedroom represents Jue Yin, the kitchen represents Tai Yin, and the living room represents Shao Yin. If the zombie is a balloon zombie, it directly flies into the backyard. The external pathogen is likened to a zombie, the cause of illness is the zombie, the location is whether the zombie is in your yard or bedroom, and the mechanism is divided into three layers: first, we must resist the external pathogen; second, there are hidden dangers; and third, our normal functioning mechanisms. The changes in these three parts after the external pathogen enters constitute the disease mechanism. Upward reversal, downward sinking, and external projection lead to the emergence of sound and forceful resistance.
Hidden dangers can be discussed in terms of the six Qi: wind, cold, heat, dampness, dryness, and fire. Besides external pathogens, there are also internal factors. When external pathogens invade, the internal six Qi will also change, leading to internal changes, such as the loss and alteration of Qi, blood, essence, and body fluids. This is akin to a railway line being cut off or a flight being canceled; it reflects the true state of war. When prescribing based on this state, those who are very accurate in their prescriptions have a precise grasp of wind, cold, heat, dampness, dryness, and fire, including their judgment of the five movements and six Qi, and they consider the changes in internal functioning. It is a comprehensive understanding and planning, allowing for precise prescriptions, making one a strategist.
When we step out of the “Shang Han Lun” and look at acupuncture, we must also consider the cause, location, and mechanism of the disease. I utilize many techniques, including auricular acupuncture, scalp acupuncture, and eye acupuncture. You may notice that my acupuncture often yields excellent short-term results, but for some diseases, the long-term effects may not be as good. In the long run, while the external pathogens may be eliminated, the five organs, six bowels, and seven emotions may not be balanced, leading to recurring illnesses. This is why my techniques have become purer over time, incorporating warming acupuncture and thread embedding.
Returning to collaterals, the twelve regular meridians and the eight extraordinary meridians are just typical examples and not the entirety. Beyond these, the connecting vessels are what link them. Recently, I have been reading a book on fascia, which seems to be out of print. From an evolutionary biology perspective, it discusses the changes in the operation of the body’s meridians. While it may not be entirely accurate, it provides an advanced thought process. When observing the human body, regardless of the perspective, it can be viewed in three layers. If you look at microorganisms under a microscope, you will see three layers. If we trace back, flattening our organs and connective tissues into a football field-sized three layers, and then reshape them into a human form, you will find that these three layers are merely increased with numerous folds and creases. When treating, can we start simply to address these complex issues? Besides the folds, there are adhesions and more energy and information transmission processes. This concept transcends the twelve meridians; the straight path is the meridian, while the collateral is the connection. I once heard an elder explain that collaterals can be divided into five types: floating collaterals, straight collaterals, oblique collaterals, crossing collaterals, and dispersing collaterals. Today, we will only discuss two: straight collaterals and crossing collaterals, which I use the most and find most effective. Of course, I also frequently use floating collaterals for bloodletting.
Let’s look at what the Jie Mai (Connecting Vessel) is, which is what we refer to as the Dai Mai (Belt Vessel), a circular vessel parallel to the Dai Mai. If we dissect it holographically, many aspects can be revealed. How do we use this in treatment? For example, if there is severe pain in the chest, affecting the surface, we can use the Jie Mai, find the corresponding point on the back, and needle the surface without going too deep, or simply use manual techniques to relieve it. This addresses the outer layer; however, if symptoms like palpitations or cough arise, it is not superficial but internal. Can we still use the Jie Mai? There is a collateral called the straight collateral, which penetrates inward like the spinal cord and can be bent to reach the interior. To treat a cough, we can find very obvious reaction points on both sides of the scapula. Does applying a medicated patch work? Yes, it does.
External treatments in TCM can be divided into three layers. The first type is a loose method similar to rolling egg therapy. The second type includes techniques like Gua Sha (scraping), massage, and other methods, which were not explicitly documented in ancient times and also belong to the loose category. The highest form is acupuncture, which utilizes muscles, tendons, skin, and bones, along with principles, methods, and prescriptions. Those loose methods can also be effective, at least serving to open the door. Currently, many patients in clinical practice have developed floating collaterals. We perform bloodletting and cupping; floating collaterals signify that the door is closed, and we are opening it. Once you understand this system, various treatment methods become straightforward; as long as you stimulate it, it will work because the body has a self-healing system. When the door is closed, knocking on it may wake it up.
Let me share a theory of quantum entanglement. When we observe this holographic theory, is it parallel to the theory of Jie Mai? This is akin to quantum entanglement theory. Recently, an experiment was conducted in China, where two quantum particles were sent, one to Lijiang and the other to Qinghai, and it was found that these two quantum particles moved identically, allowing for remote control, even when separated, they moved at the same frequency. In fact, acupuncture, whether body acupuncture, eye acupuncture, or auricular acupuncture, all revert to a common embryonic disc. This is similar to quantum entanglement theory, which shows that acupuncture is not an abstract or mystical practice.
After explaining this principle, you can extrapolate many concepts, so I do not delve into many complex details. I want to convey what straight collaterals are. Therefore, I encourage everyone to reflect more.
Regarding the concepts of rising and falling, the straight collateral represents entry and exit. I will not elaborate on rising and falling; just apply pressure to the lower area if there are muscle knots. If there are no knots, using the San Jiao (Triple Burner) circulating needle or bloodletting and cupping can also adjust rising and falling. I will share these two acupoints with you; the one inside is primarily for descending, while the one below is primarily for ascending.
In fact, I have discussed the rising and falling of Qi extensively. The area located in the lower abdomen is called Yang Qi, while the area in the chest is called Zong Qi (Ancestral Qi), and the area at the surface is called Wei Qi (Defensive Qi). Just like the sun represents Yang Qi, there are five basins below, representing the liver, heart, spleen, lung, and kidney. Each basin contains Yang Qi, merely with different names. I will not elaborate on how to use them.
Let’s discuss crossing collaterals, which originate from the “Huangdi Neijing” (Yellow Emperor’s Inner Canon) on the chapter of puncturing collaterals.
For minor ailments, we can use floating collaterals, bloodletting, and cupping. If the condition overflows into the major collaterals and cannot be addressed through the twelve regular meridians, what should we do? If there is an issue with the left ankle, needle the right wrist; if there is an issue with the left shoulder, needle the hip joint. In fact, the “Huangdi Neijing” contains many insights, but there have been deviations in transmission.
Now, let’s discuss crossing collaterals. If the straight collateral acts as a switch, the crossing collateral represents the force line. In clinical practice, I have encountered a case where pain in the lower back was connected to the right hip. I found a significant muscle knot in the scapular seam, and by following the path, I traced it to the Pi Gen (Spleen and Stomach) point and then to the painful area. I released the meridian, and the pain completely disappeared, indicating a force line. This is the crossing collateral; I have shared these concepts with you before.
Perhaps when you apply these concepts, some results may not meet your expectations, as theory and practice can differ. Therefore, let’s set aside a day for Q&A. I hope everyone continues to learn and summarize to reach greater heights, so let’s keep learning and communicating. Let’s dedicate a day for Q&A.
That concludes today’s lesson. Thank you, everyone!