Acupuncture as a way of knowing the body
针灸作为了解身体的一种方式

Acupuncture, body, way of knowing, traditional Chinese medicine
针灸、身体、认识之道、中医

The purpose of science is to understand nature, and transforming nature for the benefit of mankind is only a welcome side effect of science. However, if we were to suggest that the purpose of medicine is to know the body, and that curing diseases and improving health are only welcome side effects, that statement will incvitably lead to controversy. Nonetheless, it seems that there is nothing wrong with considering medicine as a science. On the question of how best to know the human body, people will differ in their answers; different approaches to exploring the body will be taken by scientists, artists, surgeons and gymnasts.
科学的目的是理解自然，而为了人类的利益而改变自然只是科学的一个受欢迎的副作用。然而，如果我们要说医学的目的是了解身体，而治愈疾病和改善健康只是受欢迎的副作用，那么这种说法将不可避免地引起争议。尽管如此，将医学视为一门科学似乎并没有错。关于如何最好地了解人体的问题，人们的答案会有所不同;科学家、艺术家、外科医生和体操运动员将采用不同的方法来探索身体。

How, then, do acupuncturists view the body, and what is their way of knowing the body? This question can lead not only to a body schema with
那么，针灸师如何看待身体，他们认识身体的方式是什么呢？这个问题不仅会导致 body schema
unique Chinese medical characteristics, but also to a necessary reflection on understanding acupuncture. Based on the theories of acupuncture, this paper seeks to discuss the presentation of the body across a long historical span from the perspective of knowledge generation. However, the question involved arises not because acupuncture provides a conscious expression of bodily knowledge, but because of the logical inferences made during the production of acupuncture knowledge.
独具中医特色，也要对理解针灸进行必要的思考。本文以针灸理论为基础，试图从知识生成的角度讨论身体在漫长的历史跨度中的表现。然而，所涉及的问题不是因为针灸提供了对身体知识的有意识表达，而是因为在针灸知识的产生过程中做出的逻辑推理。

Shujian Zhang, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, No. 16, Dongzhimen Nanxiao Street, Dongcheng District, Beijing 100700, China.
张淑剑，中国中医科学院针灸研究所，北京市东城区东直门南小街16号，中国 100700。
Email nirb@163.com
电子邮件 nirb@163.com

Observation is a source of all kinds of knowledge, and it is the basic approach to understanding nature and the body; its intuitive character makes it the easiest source of knowledge to accept and believe. The early theory of acupuncture was based to a great extent on observations, as can be seen in Lingshu: Jingshui (Miraculous Pivot: Meridian Waters), which says, ‘For an average man, his skin and flesh are there, and his conditions can be known by measuring for the outside parameters, and by dissecting the body after his death’. Measurement by touching the skin and dissection were two major methods of body observation in early Chinese medicinc. The theory of meridians and acupoints is an important cornerstone of acupuncture and moxibustion, and it is also the core of body knowledge in traditional Chinese medicine. Taking meridians as an example, Lingshu: Jingmai (Miraculous Pivot: Meridians) notes, ‘The twelve meridians, lying among the flesh, are deep and invisible, with the exception of the spleen meridian seen on the lateral ankle, where the skin is shallow and there is nowhere to hide it. Those surfacing and commonly seen are all collaterals.’ This makes a distinction between meridians and collaterals: those that are ‘surfacing and commonly seen’ are collaterals, while those that are ‘deep and invisible’ are meridians. However, the meridian of the spleen is visible because the muscles there are small and shallow. Another means of distinguishing between meridians and collaterals is also presented in Lingshu: Jingmai: ‘Lei Gong, a minister, asked Emperor Huang: “How do you know the difference between meridians and collaterals?” The Emperor said: “Meridians are often invisible, and their existence is known by palpation, and those visible are collaterals”.’ Here, ‘knowing by palpation’ is an act of feeling for the meridians on the body’s surface. Furthermore, a method for ‘meridian fecling’ is mentioned in the silk-bound book Meridian Finding uncarthed at Mawangdui’s Tomb of the Han Dynasty:
观察是各种知识的源泉，是理解自然和身体的基本方法;它的直观特性使其成为最容易接受和相信的知识来源。早期的针灸理论在很大程度上是基于观察，这在灵书：经水（灵枢：经络水）中可以看出，“对于一个普通人来说，他的皮肤和肉就在那里，他的状况可以通过测量外部参数和在他死后解剖身体来了解”。皮肤触摸测量和解剖是早期中医观察身体的两种主要方法。经络腧穴理论是针灸的重要基石，也是中医体识的核心。以经络为例，灵书《经脉》指出：“十二经脉，位于肉身之间，深邃无形，除了在外侧踝处看到的脾经，皮肤较浅，无处藏身。那些浮出水面和常见情况都是附带的。这区分了经络和侧支线：“浮出水面且常见”的经络是侧支线，而那些“深且不可见”的子午线是经络。然而，脾脏的经络是可见的，因为那里的肌肉又小又浅。灵书中还介绍了另一种区分经络和侧支的方法：《经麦》：“大臣雷公问黄帝：”你怎么知道经络和侧支的区别？天皇曰：“经络往往是看不见的，它们的存在是通过触诊知道的，而那些可见的就是侧支”。“在这里，”通过触诊知道“是对身体表面经络的感觉行为。此外，在马王堆汉墓中出土的丝绸装订书《经络发现》中提到了一种“经络发泄”的方法：

Press the foot flive inches from the ankle with your left hand and knock the foot’s ankle softly with your right hand. If you flnd that other meridians are strong, and only this one is weak, it indicates a disease; if other
用左手按压脚踝几英寸处，然后用右手轻轻敲击脚踝。如果发现其他经络很强，只有这条经络很弱，则表明有病;如果其他
places are smooth, and this alone is hindered, it shows a disease; if others are still, and this place moves alone, it is also an indication of a disease. (Ma, 2015: 97-98)
地方是光滑的，仅此一项受到阻碍，它就表明一种疾病;如果其他人静止不动，而这个地方独自移动，那也是一种疾病的迹象。（马，2015：97-98）

Compared with meridians, the shapes of acupoints are more apparent. Therefore, most of the acupoints were detected by observing the body’s surface in the early days of the tradition. I once examined the descriptions of acupoints in Huangdi Neijing (The Yellow Emperor’s Classic of Medicine), which states that acupoints are where morphological characteristics, such as cavitation, bone voids, crevices between bone voids, collaterals, pulsation, tendon knots and tenderness, are apparent on the body’s surface (Zhang, 2011).
与经络相比，穴位的形状更加明显。因此，在传统早期，大多数穴位都是通过观察身体表面来检测的。我曾经查阅过《黄帝内经》中对穴位的描述，其中指出穴位是体表出现空洞、骨空隙、骨空隙缝隙、侧支、搏动、肌腱结和压痛等形态特征的地方（Zhang，2011）。

Early anatomical observations are also reflected in Huangdi Neijing. At that time, the ancients still found and measured the meridians by anatomy, although their anatomical techniques were relatively crude. Moreover, the description of the working of the 12 meridians in Lingshu: Jingshui states that, in the four limbs, they can be observed by palpation on the body’s surface, but the paths inside the body were not entirely imaged by the ancients. As a one-to-one correspondence could not be established between the circulating meridians and the tissues of the body, and the ancients studied meridians mostly for practical purposes, there was no specialized discussion on the anatomy of meridians, so later generations have generally understood that meridians constitute a relatively independent physiological system.
早期的解剖观察也反映在《黄帝内经》中。当时，古人仍然通过解剖学来发现和测量经络，尽管他们的解剖技术相对粗糙。此外，《灵书：经水》中对十二经运作的描述指出，在四肢中，可以通过触诊身体表面来观察到它们，但古人并不完全想象体内的路径。由于循环经络与人体组织之间无法建立一一对应的关系，而古人研究经络大多为实际目的，因此没有关于经络解剖学的专门讨论，因此后人普遍认为经络构成了一个相对独立的生理系统。

When the meridian theory came into being, the ancients saw the meridians in terms of anatomy. Through ‘dissecting and observing’, as noted in Lingshu: Jingshui, we can know 'the rigidity and size of the viscera, the number of crevices among the joints, the length of the meridians, the cleanness of blood and the amount of $q{i}^{\prime }$$q{i}^{\prime }$qi^(')q i^{\prime}. A more concrete example is found in the biography of Wang Mang in the History of the Han Dynasty: ‘Wang Sunqing, a follower in Zhai Yi’s uprising, was captured, and Wang Mang ordered the imperial physicians, officials of the royal pharmacy and skilful butchers to cut Wang Sunqing alive, dig out his organs, explore their functions and states, and then pieree the blood vessels with sharpened bamboo thorns to
当经络理论出现时，古人从解剖学的角度看待经络。通过“解剖观察”，正如《灵书：精水》中所指出的，我们可以知道“内脏的硬度和大小、关节间裂缝的数量、经络的长度、血液的清洁度和数量 $q{i}^{\prime }$$q{i}^{\prime }$qi^(')q i^{\prime} 。更具体的例子见《汉史》中王莽传：“翟义起义的追随者王孙清被俘，王莽命令太医、御药官和熟练的屠夫将王孙清活活割开，挖出他的器官，探查其功能和状态， 然后用削尖的竹刺刺穿血管，以
understand the start and end of his meridians, saying it can cure discases.’ This is a record of an anatomical exploration of the meridians found in a history book. In Lingshu: Dongshu (Miraculous Pivot: Dynamic Transmission), it is stated, ‘Energy from the stomach is injected upward into the lung, and when its fierce force is injected towards the head, it follows through the pharynx, goes up to empty orifices before following the connective tissues between the eyes and the brain and entering the collaterals, going down to the kezhuren acupoints on the cheeks, following through the lower gum, and down to the renying acupoints on the neck through the yangming meridians.’ Such a specific description could not have been made possible without anatomical practice.
了解他的经络的起点和终点，说它可以治愈病症。这是在历史书中发现的对经络进行解剖学探索的记录。在《灵书：东枢》中，记载：“胃的能量向上注入肺部，当其猛烈的力量注入头部时，它沿着咽部，上升到空腔，然后沿着眼睛和大脑之间的结缔组织进入侧支，向下到脸颊上的可主仁穴位， 沿着下牙龈，一直到脖子上的穴位，穿过阳明经络。如果没有解剖学实践，就不可能有这样的具体描述。

The scalpels of the ancients failed to reveal the detailed and clear internal structure of the human body; even in the nineteenth century, when Wang Qingren, an anatomist in the Qing Dynasty, published Corrections of the Medical Field, the anatomical map presented was not particularly accurate. Furthermore, at the time, modern Western anatomy had been introduced to China, so Wang Qingren’s anatomical consciousness had something to do with his reading of works at the confluence of Chinese and Western medicines. After Wang Qingren, Benjamin Hobson’s Quanti Xinlun (Treatise on physiology) was published in 1851. This medical book published by a Western missionary and doctor resulted in a division between meridians and blood vessels in Chinese medicine, the influence of which has persisted to the present day.
古人的手术刀未能揭示人体详细而清晰的内部结构;即使在 19 世纪，当清代解剖学家王庆仁出版《医学领域的矫正》时，所呈现的解剖图也不是特别准确。此外，当时现代西医解剖学已经传入中国，因此王庆仁的解剖意识与他在中西医交汇处阅读著作有关。在王庆仁之后，本杰明·霍布森 （Benjamin Hobson） 的《量子新轮》（Quanti Xinlun）于 1851 年出版。这本由西方传教士和医生出版的医学书籍导致了中医经络和血管的分裂，其影响一直持续到今天。

Whether what is seen of the body is observed through feeling with the hands and fingers or through anatomy, the job is done via simple and intuitive observations. It is widely held that ‘science is based on what can be seen, heard or touched, not on personal opinions or speculative imagination’ (Chalmers, 2018: 1). Such an approach was adopted when the theory of acupuncture and moxibustion was established. Of course, the results of observation might not be accurate. For example, the anatomical map Preserving the Truth, drawn by Yang Jie, a doctor in the Song Dynasty, is inconsistent with anatomical reality in many places, and it is the result of Yang Jie’s analysis and correction by ‘proofreading against ancient books’ (Zhang and
无论是通过手和手指的感觉还是通过解剖学来观察身体，这项工作都是通过简单直观的观察来完成的。人们普遍认为，“科学是基于可以看到、听到或触摸到的东西，而不是个人观点或推测性的想象”（Chalmers，2018：1）。当针灸理论建立时，就采用了这种方法。当然，观察结果可能不准确。例如，宋代医生杨杰绘制的解剖图《保真》在很多地方与解剖现实不一致，是杨杰以“对古籍”进行分析修正的结果（张和

Zhao, 2016). The method of ‘proofreading against ancient books’ means to correct the anatomical pictures against classical theories as the standard, and it was also a practice of the "theory-ladenness of observation’. In the process of understanding the body by acupuncture and moxibustion, however, the essence of the theory infiltrated into the observation is in fact an introduction to another method for understanding the human body: speculation.
Zhao，2016 年）。“与古籍对对”的方法是指以古典理论为标准对解剖图进行校正，这也是“观察的理论性”的一种实践。然而，在通过针灸认识身体的过程中，渗透到观察中的理论精髓，其实是另一种认识人体的方法的介绍：推测。

The theories involving the 12 meridians, 365 collaterals and 365 acupoints cannot be derived purely by observation. How, then, did these classical bodily theories come into being?
涉及 12 经、365 侧支和 365 穴位的理论，不能纯粹通过观察得出。那么，这些经典的身体理论是如何产生的呢？

As mentioned above, the theoretical basis for carly human physiology is at least partly empirical facts, and partly something clse that in theory can be regarded as the ‘explanation’ of facts, which has existed since concepts came into existence. The experiences we have undergone (let us say they are true to facts) are explained when they are described. For example, the ancients observed that there were depressions on the body’s surface, and they used words such as ‘bone voids’ and ‘air pockets’ when referring to those depressions. These concepts themselves were expounded with theories: bone voids are related to positions and structure, and air pockets to functionality and morphology. Taking the theory of meridians and acupoints as an example, these can be regarded as an explanatory model, and with them, the theories can be demonstrated more conveniently. Now let us see what tools were used in the construction of the theoretical models for meridians and acupoints.
如上所述，卡利人类生理学的理论基础至少部分是经验事实，部分是理论上可以被视为对事实的“解释”的东西，它自概念出现以来就已经存在。我们所经历的经历（让我们说它们是真实的）在描述它们时得到了解释。例如，古人观察到身体表面有凹陷，他们在提到这些凹陷时使用了“骨空隙”和“气穴”等词。这些概念本身用理论进行了阐述：骨空隙与位置和结构有关，气穴与功能和形态有关。以经络和穴位理论为例，这些可以看作是一个解释模型，有了它们，可以更方便地论证这些理论。现在让我们看看在构建经络和穴位的理论模型时使用了哪些工具。

The first tool that was used was analogy. In classical acupuncture theories, analogy is found everywhere, probably due to the limitations of observation. The main target of analogy was nature, or what the ancients called ‘the heaven’. As the saying goes, ‘Man copies the heaven’; this was a basic concept for the ancients, as illustrated by the belief that ‘man is related to the heaven and carth’ (in Lingshu: Weather and Man’s Health). The number, shape, functionality and pathology of the meridians were all explained by the ancients based on obscrvation of man and nature. According
使用的第一个工具是类比。在经典针灸理论中，类比无处不在，可能是由于观察的局限性。类比的主要目标是自然，或者古人所说的“天堂”。俗话说，“人复制天堂”;这是古人的基本概念，正如“人与天和卡特有关”的信念所说明的那样（在灵书：天气与人的健康中）。经络的数量、形状、功能和病理学都是古人根据对人和自然的迷惑来解释的。根据