The Yellow Emperor's Inner Transmission of Acupuncture by Zhenhai Yang

The core text of Chinese medicine is the Huangdi Neijing, here translated as the Yellow Emperor's Inner Classic. That work, originating in ideas and practices from before the common era in the West and before the first unification of China, is thought to have been first compiled into something resembling the texts we have today during the Han dynasty (202 B.C.E.–220 C.E.), but all versions we have now have been edited and revised many times, eventually being divided into two distinct texts, the Suwen or Plain Questions and the Lingshu or Spiritual Pivot. The Suwen focused on theoretical constructions related to acupuncture and moxibustion and other treatments while the Lingshu covered the practice of acupuncture and moxibustion. Over many centuries, the importance of acupuncture waxed and waned in China, reaching a low point in the Qing dynasty (1644–1911) when the emperor's fear of assassination by needles led to the removal of acupuncture as a practice in the Imperial Bureau of Medicine. The imperial fear of acupuncture led elite physicians to avoid discussion of it in their texts. Acupuncture survived mainly among non-elite medical practitioners but was reinvented and revived in Japan in the nineteenth century and in China in the twentieth with a growing interest in responding to knowledge of Western anatomy with East Asian medical knowledge that focused on manipulation of specific points on the body. Today, Traditional Chinese Medicine (TCM) appears to have a unified concept of acupuncture points and treatment, but that only occurred as medical practitioners standardized knowledge and practice in response to Japanese and Chinese government attempts to regulate or abolish traditional medicine. The first three decades of the People's Republic of China saw the apogee of unification of Chinese medical knowledge described in great detail by anthropologists like Volker Scheid and Judith Farquhar, and the subsequent erasure of heterodox traditions. But after the death of Mao in the period of reform and opening up, many practitioners and patients became frustrated with the standardized version of Chinese medicine and sought out suppressed traditions, including religiomedical traditions related to Daoism.

The book at hand is an edited summary of one of these suppressed traditions of Daoist acupuncture theory and practice that was passed down from teacher to student over at least ten generations and finally translated into English. The introduction, by scholar-practitioner Heiner Fruehauf, argues that the book is ultimately about understanding basic human life force and how to aid this life force in self-healing the body through acupuncture. The intended audience appears to be practitioners of Chinese medicine looking for a more authentic and simple approach to acupuncture than that transmitted through the standardized system of TCM in China and the increasingly professionalized acupuncture field abroad. The book provides a fascinating primary source case study of how non-elite and nonmainstream medical knowledge survives and is transmitted.

An extended quote explains:

The needling technique that we are passing on in this book is called "Yellow Emperor's Inner Needling" (Huandi neizhen). When you first heard this name, perhaps you were slightly taken aback and thought it too grand. But it really is fitting and worthy of this name, and the transmission of the Yellow Emperor's Inner Needling is utterly profound and far-reaching. It is not an acupuncture technique made from thin air or one that we have created ourselves, but one that has been transmitted from every generation to the next. Of course … we also find advances in response to the changing times, and abundant developments. I personally received this transmission from my own father Yang Yunqing who was taught this lineage by his teacher Hu Jiayu. Master Hu Jiayu is a teacher who I have known since childhood, and beyond him there are over ten other teachers whose names are noted in the lineage transmission records.

(p. 7)

The next paragraph continues to explain how Yang's family had farmed for generations in Hubei Province and one day, presumably after 1949 but before 1966, Master Hu Jiayu settled in the small village of Renheping with few resources. Yang's father looked after the elderly migrant "like a son or daughter would" until Hu asked if he could transmit his "one special skill" as repayment. His father learned everything he could from Master Hu before he passed away in 1966, but during the ten years of the Cultural Revolution, "this sort of knowledge was treated as 'feudalistic rubbish' and nobody dared to study it" (p. 8). Zhenhai Yang himself became a geologist working for the Ministry of Nuclear Energy, but after twenty years he grew bored of this and began to feel guilt for not allowing his father to produce an heir to the transmission of Master Hu's acupuncture knowledge and began to learn from his father. His father passed away in 2000 before the oral transmission of the tradition had been fully concluded. Yang then picked up the classics to supplement the knowledge that had been transmitted to him, especially the Suwen where he identifies the "magical formula" for the approach he represents: "those who are skilled at using needles draw the Yang from the Yin and the Yin from the Yang, and treat the left by means of the right and the right by means of the left," or alternately, "[f]or Yang disease, treat Yin, and for Yin disease, treat Yang" (pp. 10–11).

A skeptic of the efficacy of Chinese medicine may not be convinced by assertions that the material body and the invisible (nonexistence) are more important than the visible (existence) and that the internal organs (Zhang Fu) are less important than Yin and Yang and Qi (p. 59). The authors quote the late Qing physician Zheng Qin'an in emphasizing that the "five Zang and six Fu Organs are all empty positions. It is the movement and flow of the two Qi that is the true dynamic in the body" (p. 59). With one major exception (The Triple Burner), the Zang Fu organs correspond in terminology to dissection-based anatomical organs like the spleen, heart, liver, lung, bladder, stomach, and so on. The authors acknowledge that this is a position very different from that of modern people who consider discussion of these organs as "reliable" while discussion of Yin and Yang as being "sheer fiction" (p. 59). They call for those practitioners who would follow their path to ignore biomedical symptoms and examinations and instead treat according to patterns, not according to disease. For example, a person with stomach pain may be diagnosed with a gastric ulcer, acid reflux, or stomach cancer but a biomedical diagnosis will only reveal how difficult the condition may be and how many treatments may be needed, but the significance is limited to this. What is needed is to "know what has been violated and why there is counterflow" and treat disease in Yang with Yin treatments (pp. 60–61).

An acupuncturist who is curious about a more spiritual approach to their practice and is unable to read the text in its original Chinese may find this book interesting and rewarding. Any historian unfamiliar with Chinese medicine should read this book along with a good historical introduction such as the brand-new Routledge Handbook of Chinese Medicine which is available for free through open access.

The translator Sabine Wilms is an excellent scholar and practitioner of Chinese medicine, but since this book is published by a university press, one wishes she had written a preface or introduction to set the proper context of the work in existing English scholarship. For example, key terms such as bianzheng lunzhi which Wilms translates here as "pattern differentiation to determine treatment" are not discussed historically at all, despite being at the center of some of the most important scholarship on Chinese medicine in the past two decades. The book has no index or proper reference material but does have a short glossary of authors and texts. For acupuncture practitioners, there are two appendices identifying key acupuncture points mentioned in the book and several glossaries of herbs and formulas.

As a non-practitioner of acupuncture or Chinese medicine, I have not studied acupuncture and theory at the level of a practitioner. But having taught undergraduates about the history of Chinese medicine and the basic theories of Yin–Yang, the five phases, of bianzheng lunzhi as both an ancient and a significantly different modern concept, I found myself uncertain what exactly in the teachings of The Yellow Emperor's Inner Transmission of Acupuncture was different from basic explanations of Chinese medical theory and practice for students or patients like those of Ted Kaptchuk.

Ultimately Yang and Liu claim to have uncovered a secret "magic formula" tradition that will purify modern acupuncture teaching which has been polluted with biomedical ideas and anatomical fixations and thus veered far off the proper path. Historians of Chinese medicine agree wholeheartedly that political challenges from biomedicine and the state throughout the twentieth and twenty-first centuries have forced Chinese medicine out from family lineages and into medical schools and university programs which have become increasingly standardized with some lineages becoming dominant while others are largely forgotten. The standardization of treatments is required in China and other nations both for consumer safety and for medical insurance payments. Max Weber wrote about the process of disenchantment and desacralization of the world through modern rationality more than a century ago and we should not be surprised at its advance in the realm of Chinese medicine, nor of the reaction against rationalization and standardization represented by this text.