7월 18, 2011

3. Characteristic of Korean Medicine - in Clinic ; Saam Acupuncture

In Ming Dynasty, Gao Wu(高武) primally mentioned method of supplementing and draining self meridian(自經補瀉法) that determine the site that apply acupuncture based on Five transport point(五兪穴), especially engendering, in Zhenjiujuying(鍼灸聚英). Also in Neijing(內經) and Nanjing(難經), applying acupuncture according to Five Phase's tonifying and dispersing theory was suggested. However, these could not suggest specific plan. Because of lack of further studies about principle people couldn't apply Five Phase Acupuncture in real clinic. Later, in Joseon dynasty, King Seonjo period, Saamdoin(舍岩道人) designed 'Saamdoinchimguyogyeol'(舍岩陰陽五行鍼刺法) that after combining engendering and restraining, take supplementation and draining point from self and other meridian(自他經) and he complete Korean Acupuncture. Saamdoin(舍岩道人) understood principle, reason and instructions of Neijing(內經) based on engendering and restraining of Five Phase, established it, proved it in clinic and devised Saam acupuncture(舍岩鍼), unique acupuncture of Korean. Therefore Saam acupuncture(舍岩鍼) is original acupuncture that inherited acupuncture method in Neijing(內經). Saam acupuncture method is based on Neijing(內經), Dongeuibogam(東醫寶鑑), Yixuerumen(醫學入門), Yixuezhengzhuan(醫學正傳), Chimgoogyeongheombang(鍼灸經驗方) and especially Saam acupuncture methods five transport part was affected by Heo joon(許浚), writer of Dongeuibogam(東醫寶鑑) and Supplementation and draining part was affected by Heo Im(許任), writer of Chimgoogyeongheombang(鍼灸經驗方). With these jobs Saamdoin establish Korean unique acupuncture based on traditional oriental medical theory. Now in China and Japan, there is Five Phase Acupuncture Method using five transport points(五兪穴), but it don't have objective standard in diagnosis and application so there is no standard that can apply commonly in clinic. Especially, Japanese learned some part of Saam acupuncture in the latter era of the Joseon Dynasty and they apply it in five phase acupuncture(五行鍼) and inform it to Western as if it was their original acupuncture. However, Saam acupuncture of Korea is unique acupuncture method that is equipped with methodical oriental medical theory.
Now we are about to introduce contents of Saam acupuncture. The Saam acupuncture works by applying acupuncture to the twelve meridians and acupuncture points called five transport points(五兪穴), on it, thereby controlling the meridian vessel. The twelve meridians are a part of the human body meridian vessels. Existing in three yang meridians and three yin meridians located each in the arm and legs; they are the main channels that let bodily qi and blood flow. The six yang meridians are connected to the five and the six bowels and the yin meridians are linked to the five viscus and the pericardium. The five transport points(五兪穴) are specific acupuncture points located below the elbow and knee, belonging to the twelve meridians and consisting of five acupuncture points from each ot the twelve meridians. Each acupuncure point is assigned to wood, fire, earth, metal, water of the five phases and is so called five phase points. The five points located on five transport points(五兪穴) is called well point(井)·brook point(滎)·stream point(兪)·river point(經)·sea point(合), starting from the point further from the elbow, knee and gradually towards the elbow and knee. Due to the fact that each of the twelve meridians have five acupuncture points appointed as five transport points(五兪穴), there are sixty five transport points(五兪穴) in total, and the arms and legs each have six of the twelve meridians(The meridians are symmetrical in left and right). The sixty acupuncture points are used in Saam acupuncture to adjust imbalance of the body and because only these are used, the patients may sometimes be confused. The acupuncture point which undergoes medical procedure may not be positioned near the body part causing pain, and can be seen to the patient as being applied acupuncture on a strange region. However even though the acupuncture is applied to a totally different region to the ailment, the sickness can be healed. five transport points(五兪穴) metaphors the flow of qi inside the twelve meridians as the flow of water, and so the names of the five acupuncture points on each meridian each have a meaning. well point(井): water gushes up from a spring, where qi from a meridian vessel comes out. brook point(滎): water flows and makes puddles, describing the flow of little water. stream point(輸): water steadily flows deeper, makes ripples to spill the spring water. river point(經): water flows flourishingly and vessel qi deep multiple abscess, good if applied in the case of yin illness. sea point(合): river water flows in to the sea, vessel qi is immense.
The principles in Saam acupuncture method follow supplementing and draining self meridian(自經補瀉)·supplementing and draining other meridian(他經補瀉) and supplementing mother on deficiency(虛卽補其母)·suppressing organ on deficiency(虛卽抑其官)·draining child on excess(實卽瀉其子)·supplementing organ on excess(實卽補其官). In order to understand the principles above, an understanding of mutual engendering and restraining of the five phases is needed along with knowledge of the categorization of the viscus, bowels, and five transport points(五兪穴) into the five phases. The five phases consist of wood, fire, earth, metal, water and wood engenders fire, fire engenders earth, earth engenders metal, metal engenders water, and water engenders wood. The term engender means the relationship in which each phase and its associated phenomena give rise to or promote another sequential phase, also the same as generating. In addition wood restrains earth, fire restrains metal, earth restrains water, metal restrains wood, and water restrains fire. The term restrain means the relationship in which each phase and its associated phenomena restrict, check or control another phase. The five viscus are the most important organs in the body and consisting of the liver, heart, spleen, lung, and the kidney, they can be categorized into wood, fire, earth, metal, water of the five phase theory in the specific order it is written above. Additionally the pericardium is added to make the twelve meridians and altogether they are the six meridian vessels of the twelve meridians. The pericardium becomes the fire phase along with the heart. The six bowels are the six important organs in the process of digestion and excretion. The components of the six bowels are the gall bladder, small intestines, stomach, large intestines, bladder, and the triple energizers. Each can be categorized into metal, water, wood, fire, and earth in the same order. Exceptionally the triple energizer is also categorized into the fire phase. The six bowels make up the six yang meridian vessels of the twelve meridians. Similarly the five transport points(五兪穴) or the five phase points well point(井)·brook point(滎)·stream point(兪)·river point(經)·sea point(合) can be categorized into wood, fire, earth, metal, water and follows the rules of the five phase theory. After we categorize the viscus and bowels into the five phases we can know about the mutual engendering and restraining relationships if the viscus and bowels, and the five transport points(五兪穴). Next we need an understanding of deficiency and excess, supplementation and draining. The Saam acupuncture views the abnormal state of the viscus and bowels as deficiency or excess and tries to return it to normal by the tonification of deficiency and purgation of excessiveness using acupuncture. Deficiency refers to the deficiency of deficiency of the healthy qi, weak constitution and weak reaction against pathogens. Term excess means excessiveness of the pathogenic qi, strong constitution and strong reaction against pathogens. Supplementation means to activate and restore a decreased function to normal, while draining means to expel pathogenic factors and thus to restore hyperactivity to normal, the same as reinforcement and reduction.
Now let’s look specifically at the principles underlying Saam acupuncture. supplementing and draining self meridian(自經補瀉) means taking an acupuncture point in the relevant meridian of the viscus or bowel and adding or reducing qi, supplementing and draining other meridian(他經補瀉) means taking an acupuncture point from a meridian irrelevant to the viscus or bowel and adding or reducing qi, The Saam acupuncture directly tonifies or purges an deficient or excessive viscus or bowel but because it also tonifies or purges organs related to the organ, it is written as above. Treatment methods that adds or reduces qi like this are expressed by supplementing mother on deficiency(虛卽補其母)·suppressing organ on deficiency(虛卽抑其官)·draining child on excess(實卽瀉其子)·supplementing organ on excess(實卽補其官). This is an application of the mutual engendering and restraining principle of the five phase theory. The one being generated in the engendering relationship is the ‘child’ and the one that generates is the ‘mother’. If we were to explain this once again if an organ is deficient, by tonifying the mother we can make the engender relationship stronger and by this tonify the child. At the same time, we purge the organ that restrains the deficient organ and by this make tonification by engendering easier. When an organ is of excess, we do it the other way around. We purge the child of the excessive organ so as to make engendering of the mother, or excessive organ easier and at the same time tonify the organ that restrains the excessive one. As shone above, the Saam acupuncture tonifies and restrains not only the organ that is deficient or of excess but also the organs that have an engendering or restraining relationship.
Now if we look at how exactly engendering or restraining is done, the two processes are done by acupuncturing on specific acupuncture points. We use the engender, restrain relationships of the organs based on the five phase theory and apply it to the five transport points(五兪穴) in the twelve meridians. If for example, the lungs were deficient we follow the next steps. The lung is categorized as a metal in the five phase theory and is currently deficient. Now under the supplementing and draining self meridian(自經補瀉) principle we tonify the earth five transport points(五兪穴) stream point(兪) and purge the fire five transport points(五兪穴) brook point(滎) of the lung meridian. Also under the supplementing and draining other meridian(他經補瀉) principle we tonify the earth five transport points(五兪穴) steam point(兪) of the earth meridian, the spleen meridian and purge the fire five transport points(五兪穴) brook point(滎) of the fire meridian, the heart meridian. There are several methods in tonification and purgation. If we turn an acupuncture needle inserted in a acupuncture point clockwise it becomes tonification and if it is turned counter-clockwise it becomes purgation. Also if we insert the acupuncture needle 45degrees towards the flow of the meridian vessel it is tonification and if it is 45 degrees against the flow of the meridian vessel it is purgation.

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