I wrote the article below for a special issue of the English acupuncture association's magazine "Acu". The special issue was about how much or how little we, as acupuncturists, should hide the "woo" aspect of our medicine. Woo is a derogatory term invented by skeptics of complementary and alternative medicine. They use the word to disparage these treatments. Woo can be translated as pseudoscience, irrationality, and not least, superstition.
Originally, my article for this issue was supposed to be about a specific point, but when I read about the theme for this edition of Acu, I was struck by the sentence: “Should we hide the 'woo' side of our medicine or should we embrace it?” This sentence immediately made me think of Sun Si-Miao's “ghost or gui points”.
From a Western medical perspective, there is probably nothing more “woo” than precisely this category of points; points that can expel ghosts from a possessed body. Both the concept that illness and disturbances of the body's physiology and mind can arise when the body is possessed by an evil spirit, and even more so, that there is a set of acupuncture points that can expel these spirits from the body again, is anathema to a Western scientific mind. So what is my own relationship to this concept and to these points? How “woo” am I, really?
Own interpretations
A major problem that many of us face today when dealing with 1500-year-old Chinese texts is that we not only lack the linguistic skills required to read the original texts, but even fewer of us have an insight into the mindset and concepts that were dominant at that time in China. This means that there is a lack of information on which we can base our understanding.
This deficiency results in some people tending to fill in the gaps, or connect the dots, with their own concepts and at times with their own wishful thinking. These approaches and interpretations do not necessarily have any connection to the reality that existed at the time and place in history where the original idea for the use of the points arose. There is at times an almost inverse relationship; the less written about a topic, the more people can project their own concepts and values into it. This does not mean that these modern interpretations are by definition wrong, or that the recommended treatment protocols do not work in practice, but rather that we should approach these modern interpretations of old approaches with critical caution.
Since I did not live in Sun Si-Miao's time, I do not know precisely what he or his contemporaries thought when they described conditions caused by gui or ghosts. However, I do know that some of the conditions that Sun Si-Miao describes as a possession by gui, modern Western medicine would probably diagnose as schizophrenia or epilepsy. Furthermore, Western medicine, which uses a reductionist model, attributes these conditions to the person's genetics and to physical changes or neurochemical imbalances in the person's brain. This is undoubtedly a valid explanation of the pathology. However, some might argue that we could still turn our conceptual telescope around and try to understand the modern world and its physiological and pathological models through the concepts that may have been prevalent at the time of Sun Si-Miao's texts.
They might argue that these physical and biochemical changes in the brain can occur precisely because the body has been possessed by a gui, in the same way that neurochemical changes occur in the brain's chemistry when we are in love, or that a broken heart can be more than a metaphorical state and can lead to physical ailments (Virani SS, Khan AN, Mendoza CE, Ferreira AC, de Marchena E. Takotsubo. Cardiomyopathy, or broken-heart syndrome. Tex Heart Inst J. 2007;34(1):76–79).
Large Intestine 11
Fortunately for me, as a practitioner of Chinese medicine, I am not limited by a reductionist physiological and pathological model. I understand the body and mind through the concept of qi. In this model, the non-material and the material body are inseparable and fully integrated. However, I still might ask myself whether a point like Large Intestine 11 has the effect Sun Si-Miao attributes to it because it expels a ghost, or whether it works in these situations because it drains Heat that rises to the Heart and agitates shen. I also rarely find myself asking if qi, shen, pathological Heat, etc. do not actually exist. Perhaps Large Intestine 11 still has its effect in these situations precisely because it activates some neurological or neurochemical response that brings the person back into psychological balance.
“Even this TCM explanation, however, can be a little too “woo” for some.”
Large Intestine 11 is certainly a point I often use to treat shen disorders, disorders that have probably at some point in history been perceived as possession by an evil spirit in the body. In these situations, I would typically use the point to drain shi or excess Heat that has risen to the Heart from the Stomach and Intestines, for example, when Heat and Dampness have resulted in Phlegm-Heat that blocks and agitates the Heart.
In this situation, I would typically combine Large Intestine 11 with points such as Stomach 40, Pericardium 5, and Du 24. Here I would use a draining needling technique. However, this is not a classic Sun Si-Miao "Ghost Point" protocol. Furthermore, the treatment itself and the underlying pathology are something I would try to explain to the patient using the concepts of modern TCM rather than concepts such as ghosts, spirits, and possessions. Even this TCM explanation, however, can be a little too "woo" for some.
"It doesn't matter whether a cat is black or white, as long as it catches mice" – Deng Xiaopeng
However, there are also times when I do use Large Intestine 11 following a specific "Ghost Point" approach. This will often be when other approaches have not worked. Here, I follow a specific two-point protocol established by Sun Si-Miao (For further reading, I highly recommend Damo Mitchell's article, which is available HERE).
I start by inserting an "innate ghost point" (a ghost point related to the patient's birth year). This point is neither tonified nor drained. I then needle Large Intestine 11 and either tonify or drain the point depending on the time of day. Although I do not personally believe that the condition is caused by a ghost or spirit, I hold the view that if this approach works, then it is the correct treatment. As the Chinese president Deng Xiaopeng once said: "It doesn't matter whether a cat is black or white, as long as it catches mice."
Acknowledgement or not?
Should I, however, still acknowledge the "woo" aspects and roots of our medicine and in these situations explain the basis of the treatment to the patient using this protocol, or should I keep it hidden from the patient? Should I explain the concept of gui possession or just say that this combination of points has historically been used for conditions that manifest in this way? Explaining the concept of gui possession might actually increase the effectiveness of the treatment for some. For others, however, it would certainly be a step too far and could weaken the patient's trust in me and thereby the effectiveness of the treatment. As always, it is important to remember that placebo and nocebo are an integral part of most treatments, both Western and Chinese medical treatments. What is beneficial in some situations can be just as harmful in others: This, however, is the core of Chinese medicine. There is no one size fits all. There are no standard treatments.
