The first thing about this worthy book which the potential reader needs to understand is that the ‘exposition’ of the title is not actually the authors’ own, but is fundamentally a reflective exposition on that of Li Shi-Zhen, one of the most important scholar physicians in China’s lengthy medical heritage. This is not to say that this is not a scholarly work in its own right, one which sets out seriously to expose material on the extraordinary vessels which has remained till now largely untranslated into English. But one of the facets of this book which marks it as extraordinary in its own right is its honest attempt to recreate and reflect the spirit of Li’s original exposition as much as to accurately represent it in English.
This may not be to everyone’s liking, because in doing so it raises as many questions as it provides answers, but this merely serves to confirm the authenticity of its approach. When it comes to the extraordinary vessels it is not merely tempting, but also quite easy, to construct apparent alternative ‘realities’ concerning their nature and functions which at best are only hinted at or often are simply absent from the source material – basing these on assumptions and personal extrapolations many of which may indeed be clinically useful, but are certainly mistaken in terms of the received texts. No agenda to debunk such myths, however, emerges from this current work. Certainly, if the final word on extraordinary vessel treatment is being sought from this text, it will surely disappoint. But if a richer perspective is being looked for, then this book holds enormous promise. In the authors’ own words, the book ‘straddles the border between the familiar and the unexplored’, and it is in the rough of the unexplored that the thoughtful and creative practitioner might find the truest diamonds which may enrich or enlighten his or her practice.
Chace and Shima are no strangers to taking on challenging material. Their earlier collaboration on the divergent channels similarly strayed from the fairways of regular acupuncture teaching, but in that work they delved painstakingly into modern interpretations of a single obscure passage in the Ling Shu. In this current work they stick much more closely to the original text and are lighter on more recent interpretations, despite obvious temptations to the contrary.
What Li did, and what Chace and Shima attempt to reflect, was combine three perspectives simultaneously in his unique original exposition, and these three are identified in this book’s title: acupuncture, alchemy and herbal medicine. It is probably the alchemical connections which readers may find the most unexpected. As modern practitioners we are apt at times to wistfully invoke the influence of ‘Daoist adepts’ or suchlike on the origins of the regular channel pathways and acupoints with little actual evidence for this idea - nor indeed much evidence of these adepts’ influence on acupuncture as it emerged in the Han dynasty. But with the extraordinary vessels there seem to be some stronger clues of these more mystical original influences. The authors suggest that what scantily survives in connection with these mysterious vessels in the early acupuncture texts may well be abstract reflections of alternative vessel/channel traditions which really were rooted in these arcane and obscure practices of such Daoist adepts. It also seems that Li himself suspected this, which is why he specifically includes these non-medical alchemical references in this exposition. Chace and Shima, in support of the Ming scholar physician, painstakingly uncover clues from venerable Daoist texts which predate the Han channel acupuncture literature but which contain clear resonances in Li’s exposition nearly two thousand years later.
The acupuncture material may also turn up the odd surprise. Li found no useful purpose in rehashing what appears to have become the contemporary currency for trade in extraordinary vessel treatment in his lifetime – the eight confluent points (some time later becoming known as the master-coupled points). He ignored them completely, and so do Chace and Shima, although they make reference to this intriguing omission, making no apology for the confusions which might arise, given the conventional approach to the vessels of today: ‘In contrast to the eight hole extraordinary vessel techniques, the methods advocated by Li Shi-Zhen are messy and potentially unwieldy’, they write.
Li also ignores the currently accepted pairings of the vessels (Ren/Yin Qiao, Chong/Yin Wei etc.) which come as part and parcel with the confluent/master-coupled points. His pairings are different, and yet somehow more obvious: Ren/Du, the two Qiaos, the two Weis, and the Chong and Dai. A secondary intriguing set of groupings also emerge out of the alchemical canon, one that is almost hierarchical in terms of deeper energetics: the Chong, then Ren and Du, then Weis and Qiaos, and wrapped around all of them the Dai.
It becomes this combination of the energetics and the terrains of the very pathways themselves which form the bulk of this exploration of Li’s Exposition, politely prodding the reader towards an equally inquisitive mindset about what these ideas might mean for better practice - in spite of the apparent messiness of the approach. ‘The clinical foment engendered by such enquiry is potentially as useful as any quasi-authoritative answer’, they write, and it will be interesting for acupuncture if this suggestion proves to be correct. Li’s treatment points alone, many of which are off the channel trajectories, provide both surprises and fascinating food for thought (these are helpfully listed in one of the appendices). The non-vessel treatment points which Li identified for the Chong, for instance, actually exceed the number of points on the vessel’s trajectory.
The authors also present their own thoughtful and methodical exposition of the pulse patterns which formed part of extraordinary vessel lore from the time of the Mai Jing. It is not the first time that the authors have attempted this, but in this instance it is presented in a context which provides the ground for further exploration by any enquiring modern practitioner. These pulse patterns clearly fascinated Li Shi-Zhen, but they have hitherto proved too obscure and abstruse to garner more than the odd quirky reference in more recent texts on East Asian medicine. It remains to be seen how this particular diagnostic lore might prove relevant in modern practice as a result of this publication.
This reviewer is no herbalist, so remains unhelpfully less than qualified to comment on a large part of this book as a result – but has enough knowledge on the subject to recognise that any serious student of Chinese or Japanese herbal medicine will find much of interest, not least because it is for his work on herbal medicine that Li remains so highly revered to this day. It is clear from even a superficial study of this part of the text that a highly creative mind was at work in the original text.
Li specifically emphasises herbal formulas over individual medicinals. This is at odds with his other better known work, the Ben Cao Gang Mu. The authors explain this by identifying in the Exposition an underlying logic which lies behind his thinking: ‘Li’s prescriptions are notable for their emphasis on the pathodynamics underlying extraordinary vessel pathologies’. The authors suggest that simply addressing the core dynamic within the pathology can produce unlikely and effective extraordinary vessel treatment strategies. The clues are not necessarily in the formulas themselves (which need not necessarily be strictly adhered to according to the case studies of more recent practitioners presented in the later chapters); the clues lie in the thinking behind them.
The book is organised into five parts. The first deals with helpful preliminaries by way of stage-setting. Part two incorporates a scholarly translation of the original material in the Exposition, including the unpunctuated Chinese source text. Part three consists of comprehensive commentaries by the authors on the original text, enriching many of the ideas hinted at earlier in the book. Part four examines the legacy of the original exposition by reviewing subsequent texts which can be identified as having been directly influenced by Li’s work, as well as some case studies. Part five consists of a series of appendices: on the acupuncture holes, on the formulas, on the single medicinals, and other information.
Chace and Shima suggest that Li reflected the mindset of his times, one of ‘inquiry, of testing and questioning the suppositions of previous ages’. Whilst this may have been the case it was clearly expedited with the greatest of respect to his sources. These same respectful qualities pervade this book, gently and dutifully turning the stones but yet still asking open and penetrating questions of what is found beneath. This particular exposition is clearly not the final word on the theories associated with treatment of the extraordinary vessels. As a wayside marker, however, it constitutes both major milestone and signpost, and can be heartily recommended as both.
Part I Preliminaries
Biographical Sketch of Li Shi-Zhen
Li Shi-Zhen’s Extraordinary Vessel Acupuncture
Keeping to the One: Internal Alchemy in Exposition on the Eight Extraordinary Vessels
An Overview of Extraordinary Vessel Pulse Diagnosis
Part II Exposition on the Eight Extraordinary Vessels
An Overview of the Eight Extraordinary Vessels
The Eight Vessels
The Yin Wei Vessel
The Yang Wei Vessel
Diseases of the Two Wei
The Yin Qiao Vessel
The Yang Qiao Vessel
Diseases of the Two Qiao
The Chong Vessel
Diseases of the Chong Vessel
The Ren Vessel
Diseases of the Ren Vessel
The Du Vessel
Diseases of the Du Vessel
The Dai Vessel
Diseases of the Dai Vessel
The Pulses of the Nine Pathways of the Qi Opening
An Explanation of Pronunciation
Part III Commentary on Exposition on the Eight Extraordinary Vessels
On the Overview of the Eight Extraordinary Vessels
On the Eight Vessels
On the Wei Vessels
On Diseases of the Two Wei
On the Qiao Vessels
On Diseases of the Two Qiao
On the Chong Vessel
On Diseases of the Chong Vessel
On Diseases of the Ren Vessel
On the Du Vessel
On Diseases of the Du Vessel
On the Dai Vessel
On Diseases of the Dai Vessel
On the Pulses of the Extraordinary Vessels
Part IV Legacy of Exposition on the Eight Extraordinary Vessels
Along the Grand Thoroughfare: Luo Dong-Yi’s Vision of Extraordinary Vessel Function
Ye Tian-Shi’s Contributions to Extraordinary Vessel Therapeutics
Shen Jin-Ao’s Contributions to Extraordinary Vessel Therapeutics
Modern Extraordinary Vessel Case Records
Vessels Wide Shut: Li Shi-Zhen’s Qiao Vessel Pathodynamics
Master Hu’s Process: The Seeds of Internal Cultivation through the Extraordinary Vessels
Part V Appendices
Acupuncture Holes of the Extraordinary Vessels
Extraordinary Vessel Herbal Formulas
Single Medicinals Entering the Extraordinary Vessels
Li Shi-Zhen’s Synopsis of Extraordinary Vessel Pulses from Pulse Studies of the Lakeside Master
Editions of Exposition on the Eight Extraordinary Vessels
People and Texts Appearing in Exposition on the Eight Extraordinary Vessels
Herb and formula index