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‘The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the causes of disease.’

THOMAS EDISON

The main principle of Chinese medicine is based on the saying ‘prevention is better then cure’, that is, preserving health is preferable to having to treat disease. Disease attacks the body when it is vulnerable. It is the aim of Chinese medicine to build strength by cultivating Chi in order for the body to withstand disease, prevent disease from becoming acute, and protect human life and the conditions that optimize its functioning. The Nei Ching states:

‘Maintaining order rather than correcting disorder is the ultimate principle of wisdom. To cure disease after it has appeared is like digging a well when one already feels thirsty, or forging weapons after war has already begun.’

It is interesting to note that Chinese physicians of old were paid when the patient was well, but received no payment when the patient developed any form of disease. To quote the Nei Ching:

‘The ancient sage did not treat those who were already ill; they instructed those who were not ill.’

and

‘The superior physician helps before the early budding of disease. The inferior physician begins to help when the disease has already developed; he helps when destruction has already set in. And since his help comes when disease has already developed, it is said of him that he is ignorant.’

The Nei Ching is widely referred to as the bible of Chinese medicine. The Huang-di Nei-Ching or the Yellow Emperor’s Classic of Internal Medicine, the source of all Chinese medical theory, is considered the equivalent of the Corpus Hippocraticum, a group of some 70 texts, compiled by Hippocrates and his followers around 400 BC, that formed the basis for Western medicine. It is the oldest of the Chinese medical texts, dating back about 4,500 years. The Classic of Internal Medicine was believed to have been written by the Yellow Emperor Huang To (2697–96 BC), who reigned in China in about 2600 BC. The book describes conversations between the Yellow Emperor and his royal physician, Chi Po. Given the complexity of the Chinese language, translation of this work has been difficult. The quotations used in this book are derived mainly from the 1972 edition of the translation by Dr Ilza Veith of California University.

Everything is Interconnected – the Web that is Nature

The Chinese medicine viewpoint is based on the systemic approach of the Western world: Human beings are a microcosm within a macrocosm. The Milky Way is a single constellation of stars within the whole universe. Earth is a single planet within the Milky Way. Human beings are only one sub-system within the super-system Earth. The individual organs inside the human body are all smaller sub-systems within the super-system of the human being. All these living systems have an interdependent relationship between them. A change in only one of these systems will have an effect on all the other systems. Chief Seattle placed this interdependent relationship in perspective in 1854 when he said:

‘This we know – the earth does not belong to man, man belongs to the earth. All things are connected like the blood that unites one family. Whatever befalls the earth befalls the sons of the earth. Man did not weave the web of life; he is merely a strand of it. Whatever he does to the web, he does to himself.’ ¹

Living systems are not static. According to the laws of physics, the universe is in constant process, therefore for every action there is an equal and opposite reaction. The same forces or energies of nature that motivate the planets to orbit around Earth and the trees to produce new leaves during spring, motivate human beings to laugh, cry, behave and their organs to function.² The balance between all these systems determines our health and hence our quality of life. In nature, imbalances cause forest fires, hurricanes, floods and earthquakes. In the human body, imbalances cause all types of illnesses such as fevers, indigestion, high blood pressure and headaches.

The Tao - the Web

According to Chinese medicine, everything that is and everything that isn’t starts with Tao (pronounced dow). What is the Tao? Directly translated, Tao means ‘Way.’ Tao cannot be defined precisely. It is not tangible and cannot be seen. It is only visible through its various manifestations and is experienced by practising its principles.³ Tao can also be translated as ‘the law of the universe.’ It is the dependence of all ‘things’ on ‘no-things’ as illustrated by Lao Tze:

‘We put thirty spokes together and call it a wheel; but it is on the space where there is nothing that the usefulness of the wheel depends. We turn clay to make a vessel; but it is on the space where there is nothing that the usefulness of the vessel depends.’ ⁴

Tao is ‘the root from which all branches grow’, ‘the source of all substance, energy, awareness.’ It is ‘a continuum without boundaries in time and space.’⁵ Tao is not a religion; it is a way of life. For years, traditional Eastern philosophy has held, but Western science has confirmed only recently, that ‘matter is nothing more nor less than condensed, highly organized energy.’ Although this is considered to be a scientific fact, it had not been applied to any medical philosophies of the Western world.⁶

Chi - the Individual Strand of the Web

Chinese philosophy refers to this ‘organized energy’ as Chi (or Qi, pronounced chee), which originates from and is motivated by Tao. It is the life force in all its manifestations, such as emotions, tissue, blood, organs, plants, flowers and animals.⁷ Chi flows from the environment into the human body through low-resistance energy points on the skin, also known as acupuncture points. These points have electrical properties that differ from the electrical measurements of the surrounding skin. The sensitivity of these points is determined by the emotional and physiological changes within the body. Chi flows throughout the human body in pathways called meridians.

Although it is difficult to measure Chi, indirect evidence of electromagnetic energy circuits involving the meridians and acupuncture points exists.⁸ Chi goes beyond the life-giving energy the human body receives from ingesting food and breathing air. Chi gives us the inborn urge to breathe, it ‘tells’ our hair to grow and our cells to replicate – it is ‘the inner knowing.’ It is ‘the substance and the activity’; it is each cell and the activities of each cell in the human body.⁹ Once inside the body, Chi provides life energy to all the body organs and body cells through the 12 pairs of meridians. When these meridians allow unobstructed flow of Chi throughout the body, the body is balanced and healthy. But if the Chi is obstructed by congestion, the balance of the body is disturbed and disease will result.

Chi is considered to be ‘the root of life’, the vital energy within the body that nourishes body and mind.¹⁰ A healthy diet, exercise, healthy breathing, good posture and limited stress will maximize Chi and ensure a healthy individual. A poor diet, lack of exercise, poor breathing and posture, and high levels of stress will deplete Chi, causing imbalances within the system, resulting in disease.

Everyone is born with Chi, and it remains with us until we die. The maintenance of health is dependent on this energy flowing freely throughout the body to animate all the body structure. Chi is constantly depleted through the pressures of daily living and must be correctly cultivated and maintained for healthy functioning.

Two types of Chi are distinguished based on its origin: ancestral Chi/prenatal Chi is inherited from our parents and acquired Chi/postnatal Chi is obtained from the food we eat, the water we drink and the air we breathe.¹¹ Prenatal Chi is obtained from two sources, the prenatal jing/essence stored in the kidneys (yuan-chi); and from the environment entering the body through the top of the head, the skin and eyes (tien).¹²

Chi is the substance, as well as the physiological functions of the organs, consequently it is in constant motion - ‘the activity of life.’¹³ It resides in the chest and is associated with breathing, blood, circulation, the heart and lungs. Chi and blood are interdependent – Chi gives blood energy and direction, without Chi blood will stagnate; blood nourishes Chi and gives it form:¹⁴ ‘… energy leads blood, which means that blood flows wherever energy goes.’¹⁵

Although Chi cannot be seen, it is believed to have been measured through sensitive electromagnetic machines, and is said to have been photographed by infrared sensitive film. So many scientists in China are now concentrating their research on Chi that a special branch of science has developed called Chi-conology.¹⁶ This research is being conducted with the assistance of practitioners of Qi Gong (or Chi Kung) - an ancient practice that involves controlling the movement of Chi around the body. Qi Gong practitioners can apparently concentrate Chi and expel it out of their bodies, and are reputed to be healthy, strong and less susceptible to disease.

A Question of Energy

As the concept of energy in healing is an important facet of this book, a short introduction is necessary to illustrate how energy is the core which links all living things in the universe.

All matter is made up of energy. The holistic health philosophy considers the human body a dynamic energy system in a constant state of change. We are all an expression of energy and this energy permeates all living organisms. Because we cannot perceive energy with the naked eye, we find it difficult to comprehend. This does not mean it does not exist.

In Chinese and Ayurvedic medicine, health is seen as the fluent and harmonious movement of energies at subtle levels. In the East, these energies have a number of names. The Indian yogis call it prana; to the Tibetan lamas it is lung-gom. It is known as sakia-tundra or ki to the Japanese Shinto, and the Chinese call it Chi. In the West, it is loosely translated as ‘vital energy’, ‘vital force’ or ‘life force.’

Vital energy represents a form of electricity. This does not mean it is electricity, but its behaviour, responses and reactions indicate that many of the laws applying to electricity also apply to vital energy. Every life function depends on this energy. According to Far Eastern tradition, it circulates in the viscera, the flesh and ultimately permeates every living cell and tissue. This energy is considered as having clearly distinct and established pathways, definite direction of flow, and characteristic behaviour as well defined as any other circulation such as blood and the vascular system.¹⁷

A great deal of research into Chi and meridians has been conducted in the last few decades, but access to this research is limited for Westerners, as it is published in Chinese. Chinese scientists are though to be piecing together the fundamental characteristics of life energy. So far, they know it has four characteristics: electric, magnetic, infrared and infrasonic. Says Dr Joshua Le, consultant to the British College of Acupuncture in London: ‘Many scientists now believe the electromagnetic recordings of Chi have proved its existence. Everyone has Chi, so it should be acknowledged by everyone, even GPs in the Western world. It’s as real as any blood vessels. The significance of this acceptance in medicine worldwide could be tremendous.’¹⁸

In physical terms, man can be reduced to a collection of electromagnetic fields. What we perceive as solid tissue is actually a mass of cells made up of chemical substances, which are themselves collections of atoms. Every atom carries an electrical charge. An atom consists of protons (positively charged), neutrons (no charge) and electrons (negatively charged). Electrons, being more easily dislodged from atoms than protons, are the main carriers of electrical charge.¹⁹ Thus, at the atomic level, the body is a mass of energy fields, all influencing each other.

The first ‘modern’ scientific evidence of energy and the human body came from Dr Harold Saxton Burr, Professor of Anatomy at Yale in the 1930s. He was convinced of the existence of ‘animal electricity’ and developed apparatus to measure electrical potential even in very small organisms. He showed that man, plants and animals are surrounded by a life-field (L-field). Each produces an electrical field that can be measured some distance away from the body and which mirrors – and could possibly even control – changes in that body. ‘Animals and plants,’ said Burr, ‘are essentially electric and show a change in voltage gradient associated with fundamental biological activity.’

Burr, the editor of the Yale Journal of Biology and Medicine, published 28 papers outlining the bioelectric nature of menstruation, ovulation, sleep, growth, healing and disease. With his colleagues, he observed that changes in life-fields indicated changes taking place in the organisms producing these fields and he used these to chart the course of health, predict illness, follow the progress of healing in a wound, pinpoint movement of ovulation, diagnose psychic trauma and measure the depth of hypnosis. This energy field or ‘aura’ can be perceived by ‘sensitive’ people, and has been ‘proven’ to exist by Kirlian photography – a technique that photographs the aura.

Another Western physician who made an invaluable contribution to the use of electrical energy in healing is Dr Robert O Becker. An orthopaedic surgeon, he was interested in the possibility of electric current regenerating broken bones. After many experiments on salamanders and frogs to examine electric currents at the site of injury, Becker proved the efficacy of his theory. Now it is possible for patients to have small hearing-aid batteries that produce a sustained negative charge implanted close to severe fractures that are reluctant to heal – with dramatic results. He was also interested in electricity as a factor in the overall control of cell differentiation and growth and he demonstrated that the right kind of current could inhibit infection, relieve pain, halt osteomyelitis, restore muscle control, repair intestinal ruptures, close holes in the heart, regenerate nerve cords and replace lost sections of the brain.²⁰

Further research conducted by Dr Bjorn Nordenstrom was revealed in the American magazine Discover. The headline read:

‘Electric Man. Dr Bjorn Nordenstrom claims to have found in the human body a heretofore unknown universe of electrical activity that’s the very foundation of the healing process and is as critical to well-being as the flow of blood. If he’s right, he has made the most profound biochemical discovery of the century.’

Inside, a 13-page article detailed Nordenstrom’s discovery of electrical polarities in the bloodstream and how he is manipulating the natural electrical circuits he has found to disperse tumours.²¹

Dr Randolph Stone, who died in 1981 in India at the age of 91, combined Eastern and Western understanding to develop Polarity Therapy. A qualified osteopath and chiropractor, he came to define techniques for balancing the energy flow in human beings through his knowledge of Eastern wisdom, his understanding of the inner structure of the universe and of the gunas, the three fundamental attributes of Ayurvedic medicine, described in Hindu literature. He developed, practised and taught Polarity Therapy in California and India with great success.²²

The West has finally discovered what the East has acknowledged for thousands of years – that a kind of electrical energy forms the basis of all life. More people are beginning to accept that the physical world is part of a much larger whole – a whole that, unfortunately, most of us cannot physically perceive. We pick up only a tiny fraction of what is really going on around us, because our concepts of life are limited by our five physical senses.

To quote Lyall Watson’s book Supernature II:

‘Earth and everything in it is under constant bombardment. We are battered by a ceaseless barrage of more than a hundred million impulses every second, a confusing avalanche of raw knowledge with which we cannot hope to deal.

‘The flood ranges from highly energetic cosmic rays, whose origin remains mysterious, but which at all latitudes have the intriguing property of coming rushing in largely from the West; through shortwave gamma and X-radiation, which passes with relative ease through our bodies; to ultraviolet and infra-red light waves that leave us with Vitamin D and radiant heat; and a wide band of radio frequencies that bring us sound broadcasting, television, radar and a scattering of information about distant galaxies in collision.

‘Most of this news is irrelevant. It contributes nothing to an organism battling for survival on a much more limited field. To prevent being overwhelmed by the flood, we have evolved barriers, which filter out the stuff we don’t need.

‘So, from all the pyrotechnics of electromagnetism our senses select just that narrow band of radiation that represents the visible spectrum – those wavelengths which lie between 375 and 775 billionths of a metre. We look on the world through a tiny slit, and this narrow window on reality is even further restricted by the censorship-taking place between the eye and the brain.’ ²³

The human ear responds to sounds within a frequency range of approximately 30–16,000 cycles per second. Human vision responds to wavelengths from 380 to 760 mill microns. Of approximately 50 octaves of electromagnetic radiations, our eyes pick up less than 1.

From the barrage of electromagnetic waves in the environment, living organisms select only those necessary for their survival. Although our brains are not geared to pick up TV waves, radio waves and ultrasonic frequencies, we do not doubt their existence, so it is clearly unwise to doubt the existence of electrical energy in the body merely because we cannot see it.

All life on Earth is intricately interwoven with the natural rhythms and laws of the universe. Every organism regulates its metabolic activity in cycles attuned to the fluctuations of the earth, sun and moon. So cosmic forces directly and indirectly have an effect on us humans which is beyond our control. To quote Lyall Watson again:

‘Our internal clocks are clearly tied to the rhythms provided by the planet and its nearest neighbours in the solar system. We wake and sleep, sweat and shiver, urinate and breathe in time with cosmic cues that are often so subtle that medical science has had a hard time taking them seriously. But an avalanche of studies in the last (few) decades on insomnia, menstrual irregularity and stress in those suffering from cyclic disturbances such as jet lag has turned the tide. It is now more widely accepted that functional integrity, the basic processes of growth and control, and the efficient working of the central nervous system are all maintained to a very large extent by our electromagnetic environment.’ ²⁴

This brief synopsis barely begins to encompass the vastness and multiplicity of phenomena occurring around us all the time, but it is intended to emphasize the importance of the interconnectedness of all things and how health is dependent on vital electrical forces. The optimum state for each individual is to live in harmony with nature and the surrounding environment. And it is the role of the reflexologist, working in accordance with holistic philosophy, to help people to work towards and achieve this state of balance.

Yin/Yang Theory

Yin and yang is the earliest scientific principle recorded in traditional Chinese medicine. It replaced superstition, as all changes were previously explained in terms of spirits and demons.²⁵ Yin and yang are the two forces that move the world, two manifestations of being, and two complementary and contrasting energies. For the Chinese, yin and yang do not exist separately – they correspond to the two sides of the same coin; being a single principle they cannot exist in isolation. Day and night are inseparable; one cannot exist without the other. Yin and yang are in a state of continuous movement. Energy is not stagnant – by definition it moves. Pathologies, therefore, are energy blockages caused by excess or deficiency.

Yin and yang are two opposite but complementary and interdependent poles of the energy or Chi generated by Tao.²⁶ Ilza Veith, in the introduction to her translation of The Yellow Emperor’s Classic of Internal Medicine states: ‘… Yin and Yang were conceived as one entity and that both together were ever-present.’ Nature as a whole, including human beings, is composed of these two forces, in other words a yin or yang ‘value’ can be designated for all phenomena, including cosmic processes. These two opposing energy forces are relative to and interdependent on each other. A yin is only a yin in the presence of a yang and vice versa. Chee Soo illustrates this interdependent relationship between yin and yang with the following metaphor: ‘For a cup (yang) is only a cup when you have a void (yin) in the centre.’²⁷

Fig. 1 Yin/yang symbol

In reality, neither of these two forces are absolute – yin has a little piece of yang in it and yang has a little piece of yin in it (see above). Under certain conditions, yin can become yang and vice versa. This ability to transmute initiates all changes in nature, as a change in one element will affect all other elements, due to their interdependent relationship. Yang is illustrated in traditional Chinese medicine as the ‘sunny side of the mountain.’ It represents the male principle: active, positive, heat, fire, light, fat, dryness, the sun, it flows upwards and outwards and expands. The ‘dark side of the mountain’ illustrates yin.²⁸ It represents the female element: negative, passive, cold, thin, destructive, the moon, the Earth, night, water, dampness, darkness, death, it flows downward and contracts. In order to obtain balance or equilibrium, both of these opposing energy forces must be present: for example, in order to have birth there must be death, to have day there must be night, to have movement there must be stasis.²⁹

Note: The fact that yang represents the positive and yin represents the negative does not imply that yang has a positive value and yin has a negative value. It is purely an indication that they are two opposing polarities. No deeper interpretation, meaning or value should be attached than this.

It is said that heaven was created by the accumulation of yang and that Earth was created by the accumulation of yin.³⁰ Human beings are the result of the interaction between the yang of heaven and the yin of Earth – the ‘offspring of their union.’³¹ Humans draw energy or Chi from heaven and Earth and transform it into an energy system suitable for the body’s organs and their functions.³² Implicit in this is the fact that human beings are interwoven with nature and cannot be separated from it.

The polarity of yin and yang therefore also applies to humans in terms of the structure and functions of their bodies. It guides the functions of every organ in the body, and organs are paired relative to each other according to the yin/yang principle.³³ Traditional Chinese Medicine (TCM) uses the principle of yin/yang to analyze, diagnose and treat a disease. Yang symptoms, according to TCM, are fever, sweating, constipation, chronic thirst, dry lips and mouth, dark urine, heavy breathing, rapid pulse and irritability. Yin symptoms are loose bowels, lack of thirst, shallow breathing, slow pulse, lethargy, chills, cold hands and feet (circulation).³⁴ Illness manifests as external symptoms, which is an indication of a yin/yang imbalance inside the body or between the body and its environment.³⁵ In treatment, TCM aims to correct this imbalance, which will bring natural relief of the symptoms. Western medicine, on the other hand, focuses on relieving the symptoms only, irrespective of its cause.

A healthy body has the ability to adapt rapidly and to alter constantly the proportion of yin to yang (and vice versa). In this way, balance is maintained throughout the body and disease is prevented. A body that lacks the ability to change and adapt will carry an extreme yin or yang polarity. This will cause an imbalance and consequently make the body prone to disease.³⁶ Beinfield and Korngold describe this state of imbalance and disease thus: The man is not sick because he has an illness, but has an illness because he is sick.’ Perfect balance between yin and yang within the body and between the body and external environment, implies a healthy body, mind and spirit.

The Theory of the Five Elements

It is said that the theory of the Five Elements or five phases was introduced to Chinese medicine from India. The Five Elements are created due to the interaction between yin and yang, which is why the Five Elements are also considered to be energies. The Five Elements can be viewed as the manifestation and behaviour of Chi within five specific cycles.

In this way, five interdependent, opposing and complementing cycles (energies) of transformation were identified within the yin/yang principle: birth, adulthood, maturity, aging/degeneration and dying. The Taoists gave these cycles names: birth (wood), adulthood (fire), maturity (earth), aging/degeneration (metal) and dying (water).³⁷ A change in one of the elements will affect all the other elements. The dynamics of the Five Elements describe the process of change within an organism and between an organism and its environment. An ancient Chinese treatise states: ‘By the transformation of yang and its union with yin, the Five Elemental Energies of Wood, Fire, Earth, Metal, and Water arise, each with its own specific nature according to its share of yin and yang.’³⁸

Wood is associated with active functions and growth, fire includes functions that have reached a maximum state of activity and are about to decline to a resting period, earth represents a neutral state of balance, metal includes functions in a declining state and water reflects those functions that have reached a state of maximum rest preparing to change direction in activity.³⁹ The Five phases are evident in all aspects of nature: ‘All things contain all Five Elemental Energies in various proportions.’ The seasons manifest through these five phases: spring (wood), summer (fire), late summer (earth), autumn (metal), winter (water). Because human beings are part of nature, these five energy cycles are applied to the human system, their physical, sensory, perceptual, emotional, intellectual and spiritual life.⁴⁰ Ilza Veith writes:

‘Man who is said to be the product of heaven and earth by the interaction of Yin and Yang also contains, therefore, the Five Elements.’

In this light, Five Element theory was extended to include human behaviour.⁴¹ The relationship between the Five Elements forms the basis for the prevention, assessment and treatment of disease, as it describes the physiology of the human body in relation to its environment. The Five Elements are interdependent and interaction between these elements happens in two cycles reflecting our yin/yang nature.

A generating cycle/yin cycle

This cycle is also referred to as the ‘Mother-Son Law’, as each element is the ‘mother’ of the next element and the ‘son’ of the previous element. Each element produces the next element and supplies it with energy – wood creates fire, fire creates earth, earth creates metal, metal creates water, water creates wood. In the context of the natural world, the following cycle occurs: wood burns creating fire, fire produces ashes creating earth, earth holds within it different minerals represented by metal, metal is a mineral of the earth and in liquid form it is similar to water, water gives life to wood which is represented by the trees and plants; the cycle then starts again.⁴² It is important to note that no single element has more value than another. Each element and the functions it performs are important, as they are all interdependent.

Fig. 2 Generating/control cycle

A control cycle/yang cycle

Each element exerts a type of control over another in order to maintain balance throughout the system. If one element becomes too strong it will ‘attack’ and ‘injure’ another element. By the same token, if an element becomes too weak it will be ‘attacked’ and ‘injured’ by another element. This will result in an unbalanced system. In nature, this control cycle is evident in the way that wood controls earth by means of roots keeping the soil in place and preventing erosion; on the other hand, roots can also uproot earth and deplete it by drawing out nutrients from the earth. Earth exerts control over water by providing boundaries, so preventing flooding; however, earth can also restrict water from flowing freely when it dams or absorbs water. Water controls fire by preventing it from blazing and getting out of control, yet water can also extinguish fire. Fire controls metal by allowing it to be flexible and take on different forms by softening or melting it. Metal controls wood by cutting or chopping it down, preventing it from becoming overgrown and allowing space for other living organisms; but metal can also destroy wood completely by cutting too much down.⁴³

 Wood generates fire by controlling earth;

 Fire generates earth by controlling metal;

 Earth promotes metal by controlling water;

 Metal promotes water by controlling wood;

 Water promotes wood by controlling fire.

The following example illustrates the interaction between the Five Elements from a Western medicine and a traditional Chinese medicine point of view. During congestive heart (fire) failure, changes in the lungs (metal) occur due to the fact that the blood can no longer flow to and from the lungs in order to excrete carbon dioxide and absorb oxygen. The affected lungs will subsequently cause cellular dysfunctions in the liver (wood). The congestive heart failure also causes pressure and congestion in the liver due to blood accumulating in the veins feeding the liver. The malfunctioning of the liver (wood) causes malfunctions in the spleen (earth).⁴⁴

The yin and yang cycles operate simultaneously, creating a feedback system, in order to bring about and maintain balance in nature and throughout the human body.⁴⁵

Every person has a natural and spontaneous affinity towards one of the elements. All Five Elements exert an influence in one’s life, but one will be manifest stronger than the others. Together, the Five Elements have a direct influence on a person’s personality, emotions, spiritual needs and predisposition to physical weaknesses. The two opposing but complementary cycles containing the Five Elements, being yin and yang, operate simultaneously in order to achieve balance in nature, as well as throughout the human body. Balance will result in good health, while imbalances between the elements and its two cycles will result in disease.⁴⁶

A detailed analysis on each of the Five Elements is provided later in this book (see here). It is first necessary to understand a few further theories underlying TCM, as these theories will be integrated within the analysis of the individual elements.

Examination and Diagnosis

During examination, information is gathered in order to identify the symptoms, which will indicate any underlying imbalances. Analysis classifies these imbalances, and a decision is made as to how they will be treated and the balance restored.

The information obtained from the examination is integrated and organized, utilizing the principles of TCM to identify a specific group of symptoms. These groups of symptoms are referred to as symptom-complexes.⁴⁷ A symptom-complex goes beyond a symptom. It is a summary of the functioning of the body at a specific phase or stage of the disease. It includes the symptoms manifested and connects these symptoms to imbalances in the body. The cause of the imbalances, location and nature of the disease are then identified. A decision is made based on these findings with regards to the treatment required.⁴⁸ The aim of the treatment is to regulate the relationship between the factors of the symptom-complex by applying the yin/yang theory, restoring balance to the meridians and consequently the whole body.

The patient is always examined and assessed from the following perspective: the body functions as a whole, all body parts are interdependent, and the body and its environment are interdependent. Ohashi illustrates this interdependency when he says:

‘In Oriental diagnosis, we see the body as an orchestra whose music is the soul. Remove any instrument, or change the way it is played, and you alter the music entirely. To bring out the full breadth of the spirit, you must finely tune each organ as if it were an instrument. It must function optimally, as if a virtuoso was playing it. Yet you must never forget that each organ must blend harmoniously with the rest of the body – all the other pieces of the orchestra – to bring forth the most complete and beautiful being, which is you. The Oriental healer, therefore, is like the conductor of an orchestra. He or she hears the instruments that are playing out of tune and adjusts them to bring each into harmony with the rest of the orchestra.’⁴⁹

The Theory of the Causes of Disease

The causes of disease are inherent to the theory of the Five Elements. As we have seen, the Five Elements are manifestations of the vital life-giving energy or Chi. Balance between the Five Elements, and therefore the flow of Chi, will promote and maintain longevity and good health. Imbalances in any of the Five Elements, implies an imbalance in the flow of Chi, which will result in disease. According to TCM, disease derives from one of two causes.

Environmental factors

If the human body lacks the ability to protect itself from harmful external environmental factors, imbalances will occur and disease will result. These factors are related to abnormal climatic conditions. When climatic conditions are in excess or lacking it disturbs the balance between the body and the environment.⁵⁰ Chinese medicine refers to these abnormal climatic conditions as ‘the five devils.’ The five devils are associated with the Five Elements and the major organs inside the human body.

 Wood is related to the climate wind, affecting the gall bladder and liver;

 Fire is associated with the climate heat and affect the heart, small intestines, circulation and triple burner;

 Earth is associated with the climate dampness, affecting the stomach, spleen and pancreas;

 Metal is related to the climate dryness and affect the lungs and large intestine;

 Water is related to a cold climate affecting the bladder and kidneys.

The degree to which each of the climatic conditions will influence the individual is dependent on his/her affinity with each climatic condition and the strength of their Chi to protect the body against these external attacks.

While Western medicine identifies the external factors causing disease as bacteria and viruses, Chinese medicine does not specifically refer to these as external causes of disease. However, they can be accommodated within the Chinese medicine paradigm.⁵¹

Internal dysfunctions

Internal dysfunctions in the human body are related to extreme, intense emotions. These are referred to as the ‘five destructive emotions’ and they are associated with the Five Elements and with the major organs of the human body. The Five Elements are related to the five emotions as follows:

 Wood is related to anger, affecting the gall bladder and the liver;

 Fire is related to joy, affecting the heart and small intestines, circulation/pericardium and the triple burner;

 Water is related to fear, affecting the bladder and kidneys;

 Metal is related to grief and worry, affecting the lungs and large intestines;

 Earth is related to sympathy and needs, affecting the stomach, spleen and pancreas.

When one or more of these emotions is experienced in extremity and excess, or when we are unable to express or experience these emotions properly, this causes imbalances in the Chi flowing through the body. These imbalances deplete the body’s ability to protect itself against both internal and external attacks on the body and disease will result. Other internal causes of disease include tension, overexertion, dietary maladjustments, excess sexual activity, excess mucus, blood clotting, and heredity dysfunctions.⁵²

All these internal and external factors are interdependent and their interaction with each other leads to specific groups of symptoms. These symptoms are manifested physically (external or internal) and emotionally (in terms of behaviour) as described by the dynamics of the Five Elements and are indications of imbalances within one or more of the elements.⁵³

Today we are once again beginning to learn what the Chinese knew thousands of years ago, that disease is mostly the result of wrong living – not living in accord with the natural laws of the universe. Ancient Chinese philosophy regarded the human organism as a miniature version of the universe and often referred to man as ‘the small world.’ Thus, man cannot be divorced from nature as he forms an organic part of it. Nature as macrocosm and man as microcosm obey the same laws. The Nei Ching says:

‘Those who rebel against the basic rules of the universe sever their own roots and ruin their true selves. Yin and yang, the two principles in nature, and the four seasons are the beginning and the end of everything and they are also the cause of life and death. Those who disobey the laws of the universe will give rise to calamities and visitations, while those who follow the laws of the universe remain free from dangerous illness, and they are the ones who have obtained Tao, the Right Way.’

Meridian Theory

The meridian theory represents the anatomy of the human body according to Chinese medicine. The Nei Ching states:

‘The Meridians move the Chi and Blood, regulate the Yin and the Yang, moisten the tendons and the Bones, and benefit the joints … internally the Meridians connect with the Organs and externally with the joints, limbs and the outer surface of the body.’⁵⁴

The meridians are a network of energy channels of which there are 12 major ones (see here). Each meridian passing through the one side of the body has a mirror image on the other side of the body, resulting in 12 pairs of meridians. In order to maintain health, the circulatory and nervous system must be able to flow uninterrupted throughout the body; if it is not something is bound to go wrong. The same principle applies to the meridian network. When Chi flows uninterrupted throughout the body via the meridians, good health will be achieved and maintained. The environment (external factors), our thoughts and emotions (internal factors), and what we eat, drink and breathe all affect the flow of Chi in the meridian network, as indicated by the theory of the Five Elements.⁵⁵

The flow of energy or Chi through the meridians happens in specific cycles within a 24-hour period. The energy flows at a maximum level for a period of 2 hours in each meridian and at a minimum level 12 hours later. This implies that a specific meridian and its connecting organ will dominate the body during a specific 2-hour period. If the Chi in this meridian is in shortage and consequently imbalanced, related symptoms will be felt intensely during this time period. (This is discussed in more detail in Chapter 4 under each individual meridian.)

Acupuncture or acupressure points are located along each meridian, which are linked to the structure of the organs. If a meridian is congested, stimulation of these points will allow energy to enter the meridians. Alternatively, if a meridian is overloaded with energy, stimulation of the acupuncture points will release the excess energy.⁵⁷ Stimulation of the meridians clears congestions, and restores balance and health within the body, hence improving the flow of Chi.

Western medicine recognizes a nervous system and a circulatory system within the human body, but focuses on the structure and functions of each individual organ. Although, for instance, the circulatory system supplies each organ with the nourishment necessary to allow the functioning of all organs possible, Western medicine does not consider this interrelationship as significant. Western medicine sees the circulatory system as just another organ and analyzes it in terms of its structure and functions separate from all the other organs. In TCM, each individual organ is understood in terms of its functions and its structure. However, the structure of each organ is not looked at solely in terms of the cells, membranes and mechanisms that go to make it up. Instead, the structure of each organ consists of the organ and the meridian responsible for nourishing that specific organ with live-giving Chi. Included in the structure of each organ is how that organ relates to, influences and is influenced by the other organs and their meridians, as indicated by the theory of the Five Elements.

Although we refer to 12 major meridians, in fact there is only one single meridian running throughout the whole body, as all of these meridians are connected to each other, flowing into one another. They are bilateral (paired), giving 24 separate pathways. Each meridian is connected and related to a specific organ from which it gets its name – in most cases the organs are ones with which we are familiar. In addition, it is connected to a coupled meridian and organ with which it has a specific relationship. The coupled meridians consist of a yin and yang aspect, and come under the dominance of one of the five elements (see table below).

ELEMENT	YANG ORGAN	YIN ORGAN
Wood	Gall bladder	Liver
Fire	Small Intestine/Triple Burner	Heart/Circulation
Earth	Stomach	Spleen/Pancreas
Metal	Large Intestine	Lungs
Water	Bladder	Kidneys

It is difficult to draw a dividing line between the anatomical and physiological concepts of the Nei Ching. The organs are described for their function rather than for their location and structure, and the idea of cosmology (the continuous interaction of yin and yang, the four seasons and the five elements) dominates the theories of structure as well as those of function.

According to the Nei Ching, the body has five ‘viscera’ and six ‘bowels.’ The viscera, which are yin, are the heart, spleen, lungs, liver and kidneys. These have the capacity to store but not eliminate. They determine the function of all the other parts of the body, including the bowels, and also of the spiritual resources and emotions. The function of yin organs is to produce, transform, regulate and store the fundamental substances – chi, blood, Jing, shen (spirit) and body fluids. Jing is best translated as ‘essence’ and is the substance that underlies all organic life. It is the source of organic change and is generally thought of as fluid-like. Jing is supportive and nutritive and is the basis of reproduction and development.

The six bowels are yang organs and have the capacity of elimination but not of storing. These are the gall bladder, stomach, large intestine, small intestine, bladder and the triple burner (triple heater or three burning spaces). The triple burner is not an actual organ, and will be discussed in more depth in the detailed description of the meridians (see chapter 4). The yang organs receive, break down and absorb that part of the food that will be transformed into fundamental substances, and transport and excrete unused portions.

The position of the viscera and bowels is compared to that of various officials in an empire, relating to the 12 main organs and meridians. The 12 officials must always work together for the maintenance of the whole, and never fail to assist one another.

‘When the monarch is intelligent and enlightened, there is peace and contentment among his subjects; thus they can beget offspring, bring up their children, earn a living, and lead a long and happy life. And because there are no more dangers and perils, the earth is considered glorious and prosperous.’

In addition to the 12 organ meridians, there are also 2 ‘vessel’ meridians termed the ‘governing’ and ‘conception’ meridians. They serve as energy reservoirs for the entire meridian network. The governing meridian (the Du channel) stores energy for and supplies energy to all the yang meridians within the body. It has its origin in the pelvic cavity. From there it descends internally, surfacing at the perineum, passing through the tip of the coccyx. It ascends along the spine, the neck, over the head, descends along the middle of the forehead and nose, ending inside the upper gum. A smaller internal branch ascends from the pelvic cavity, through the buttocks to the kidneys. Another small internal branch leaves the main meridian at the base of the head and enters the brain.⁵⁷

The conception meridian (the Ren channel) stores Chi and supplies it to all the yin meridians. It is called the conception meridian as it is thought that in women it originates in the uterus and is responsible for the development of the foetus. This meridian starts in the pelvic cavity, emerging at the perineum and ascends over the middle of the pubic area. From there it ascends along the middle of the abdominal area, the chest and throat to the chin. Here it penetrates and encircles the lips internally. Two internal branches pass from the lips on either side of the nose ascending over the cheeks, parallel with the nose ending underneath each eye.⁵⁸

The meridians all have two sections – one section is close to the surface of the body and the other is internal and deeper inside the body. Each meridian and its connecting organ can be classified in terms of the yin/yang principle. Organs that are hollow, most often externally situated within the body cavities and involved in the process of discharging substances, are considered to be yang organs. These organs are responsible for the reception, transmission and digestion of food and liquids and the elimination of wastes. Solid organs, positioned more internally in the body and involved in the absorption, regulation and storing of various substances are considered to be yin organs. The meridians connecting these organs can be classified as supplying these organs with either yang or yin Chi. The meridian energy network connects the environment surrounding the body to the internal organs. The course of each meridian plays an essential role in the diagnosis and treatment of diseases, as postulated by traditional Chinese medicine.

To recap, reflexology works to help attain and maintain the equilibrium in the Chi by activating the sections of the meridians present on the feet, as well as activating the reflexes of the organs relating to each of the meridians. This is why it is important to incorporate the concept of meridian therapy with the practice of reflexology.

Chinese medicine is essentially holistic. It is based on the idea that disease cannot be isolated from the patient and that no single part can be understood except in its relation to the whole. Nothing is treated symptomatically. According to the Nei Ching:

‘Illness is comparable to the root; good medical work is comparable to the topmost branch; if the root is not reached, the evil influences cannot be subjugated.’