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Book Review: An Exposition on the Eight Extraordinary Vessels: Acupuncture, Alchemy, and Herbal Medicine

by Scott R. Smith

After receiving this book and flipping through some of its 500 pages, I laughed and wondered if I had taken on too much. Sure, itís only a book review, but I was given the responsibility to not only read through the text but to positively or negatively evaluate the book in hand through careful analysis of its content, style, organization and so forth. Other books Iíve reviewed in the past were closer to clinic manuals. Being a clinician, it was fairly easy to judge whether or not the material was useful and well-presented. This book is more intense. Its content is ambiguous, really challenging one to keep an open mind regarding Liís approach to the extraordinary vessels.

This is a translation of Li Shi-Zhenís Exposition on the Eight Extraordinary Vessels. The first English translation of this 16th century text is an attempt to elucidate Liís rationale in merging or uniting Daoist teachings and practices with acupuncture and herbal medicine. Charles Chace and Miki Shima, two respected practitioners and linguists in the field of Chinese medicine, have taken on quite a task of translating, organizing and commenting on Liís theories, perspectives, principles, and approach to the eight extraordinary vessels in acupuncture and herbal medicine.

The biggest question for me when purchasing a book in the field of medicine is whether or not it will be applicable to my practice and patients. Just because something is translated or commented on in depth doesnít mean the benefit necessarily extends beyond the author, translator, or publisher. On the question of practicality, I was pleased to read that the information was useful. Yet the translators are very clear that the book is not about point combinations or the like, but an inclusion into the interpretive medical tradition that encourages practitioners to make the material their own. Thatís the key here: make it your own. As practitioners, this is a chance to diverge from what is normally taught in institutions today. This means putting aside the master-couple points. This means building an herbal prescription built on extraordinary vessel pathology instead of a using single herbs or classical prescriptions.

Itís not a quick reference for acupuncture combinations, yet they are included throughout the text. It is not a quick herbal medicine reference either, yet youíll find herbal prescriptions and single herbs associated with the extraordinary vessels. So what does that leave one? Liís Exposition is a text about synthesis; about a familiarity with the physicians world and the world of those focused on internal cultivation. In short, this is a book about Liís perspectives on the extraordinary vesselsí application in the areas of acupuncture, herbal medicine, and Daoist meditative practices. What one gains from a work such as this I suppose depends on oneís intent, skill level and understanding.

Despite the size of the book, The Exposition is a short work based on Liís own understanding of extraordinary vessel functions and relationships. Li cites extraordinary vessel theory described in earlier works such as The Classic of Difficulties, and then elaborates a fresh approach. Li does this with the alchemical, herbal and pulse material as well, for example, he bases the extraordinary vessel pulse discussions off of Wang Shu-Heís Pulse Classic.

The extraordinary vessel master and couple points that are so ingrained during school seem to have no more importance to Li than any other point that lies on the same pathway. Clinicians may take on different treatment approaches based on this allowing one to focus more on the reactive point along the vessel trajectory as opposed to using a point based on classical indications. As Chace and Shima remark, One disadvantage of relying too heavily on eight confluent hole methods of extraordinary vessel treatment is that they have the insidious tendency of distancing the practitioner from the extraordinary vessels themselves. It becomes very easy to needleÖand to think, ĎThere! Iíve accessed the yin qiao,í without having to give much thought to its trajectory or the state of qi within it.Ē

Liís ideas about treating the extraordinary vessel course as opposed to a single point almost parallel his view of herbal application. Here itís less about the single herb-extraordinary vessel association, and more about the formula used to treat the pathodynamics characteristic of each extraordinary vessel. But donít assume this text is herb Ė focused, as formulas for some of the vessels are sparse or nonexistent.

A work such as this is wide open to assumptions, interpretations, and leaves one with many questions: What is the medical use of the extraordinary vessels? How much does one need to focus on personal transformation in order to understand and apply Liís approach to the extraordinary vessels? What is Liís approach and should I adopt it? Are these exercises or fundamental tools? Is this an approach that simplifies diagnosis and treatment to its core? Since none of Liís case records exist, we are left with more of a theoretical approach. To help guide how Liís approach may be applied clinically, the translators explore the ideas of physicians that follow Li and analyze the direction of their extraordinary vessel understanding.

The book is well organized and has a cohesive flow. Part I: Preliminaries sets the tone for the rest of the book including a biographical sketch, thoughts on acupuncture and herbal medicine, intro to internal alchemy and an overview of pulse diagnosis.

Part II is the annotated translation of Liís Exposition on the Eight Extraordinary Vessels. Each vessel is covered along with pertaining diseases, point usage and herbal formula associations. The section concludes with discussion on pulses and their associated vessel.

Part III: Commentary on the Exposition follows the same organization as Part II, but includes full commentary.

Part IV: Legacy covers ancient physiciansí contributions to the extraordinary vessels and modern case histories.

Part V: Appendices includes tables of acupuncture points, listed herbal formulas, single herbs and associated vessel, pulse synopsis, editions of Exposition on the Eight Extraordinary Vessels, and tables of historic figures and texts mentioned in the translated work.

The more you read this book, the more you realize that opinions range widely as to the meaning of words, passages, clinical usage etc. For example, in Chapter 22, the final section of the chapter on diseases of the wei vessels, we are presented with wei vessel strategies for lumbar pain. But as you read on, the vessel trajectory is questioned as are the point locations. So itís a book filled with thoughts such as, ďWell maybe, he refers to this but that work doesnít exist anymore, hereís what Li said, but another author translates it as this, and another one as this, so, letís come to a happy medium and just assume thisĒ -- which can be tough for someone who is looking for a straight answer.

To have visual material immediately accessible, it would have been nice to have illustrations of each vessel trajectory, including points, incorporated with each vessel chapter. This would have been more useful than the included book marker with a colourful orb designed to illustrate vessel topography.

In summary, there is no doubt that Liís discourse on the extraordinary vessels is innovative. Liís intent is that both perspectives, medical and alchemical, are blended by the practitioner to allow comprehension of the 12 channels and 15 networks. If, when and how this happens is up to the reader.

Scott R. Smith is a licensed acupuncturist and herbalist (Dipl. OM, NCCAOM) practicing in Rapid City, SD. He can be emailed at

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