人体のメカニズムは一般によく小宇宙に例えられるが東洋医学的に具体的に理解を深めようとすれば、もっと小さな空間で例えを作った方が解りやすいかもしれない

 The mechanism of the human body is often likened to a "microcosm." However, to truly deepen our understanding from the perspective of Oriental Medicine, it may be easier to envision it within a more contained, tangible 

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In a distant realm, there exists a unique nation composed of twelve distinct cities. The most remarkable characteristic of this country is that all its vital functions are governed by a mysterious substance known as "Ki."

Ki is energy itself, deeply interwoven into every operation of the state. Yet, no one has ever seen its true form—for Ki is, by its very nature, formless. Thus, while its presence can be measured in magnitude, it can never be counted in units. Governed by immutable laws, Ki courses through the nation in every direction, never ceasing its movement.

The nation is formed by twelve cities, each fulfilling a specialized and essential role. Whether acting independently or in coordination, they maintain the functional integrity of the whole.

These cities are interconnected by twelve primary canals forming a continuous loop. This network is further supported by fifteen secondary horizontal canals and eight dams. Among these eight dams, two are of paramount importance, serving simultaneously as reservoirs and vital conduits.

All canals flow incessantly in a fixed direction according to strict principles. While flow may occasionally stagnate in certain areas, the total circulation never stops. Should the flow in even a single canal be severed entirely, it would signal the "beginning of the end" for the nation.

The specialized fluid that fills these canals is called "Ketu." While Ketu is generated from Ki, it differs in that it possesses a tangible, physical form. Ketu is driven by the power of Ki; it lacks the capacity for independent movement. Therefore, unlike Ki—which can permeate anywhere—Ketu cannot operate outside the canals and dams.

Every function of the nation is powered by Ki, including the opening and closing of the "Gates" that regulate canal flow. Both Ki and Ketu are finite resources that are constantly consumed; thus, they must be perpetually replenished.

This replenishment comes from external supplies, which are transformed into Ki and Ketu through the collaborative efforts of the cities. Here lies a relationship like a Mobius strip: for the cities to function smoothly, Ki must provide sufficient power, but for Ki to regain its vitality, the cities must function smoothly.

Ki is automatically regulated by the twelve cities to ensure the nation operates efficiently. When the volume of Ki is insufficient, the country’s strength inevitably declines. However, there are times when the nation falters even when Ki is seemingly abundant.

This occurs when the nation lacks a "Clear Vision." Without a unified direction, the cities lose their ability to govern Ki effectively. When a firm sense of purpose is restored, the nation revitalizes almost instantly.

The country is influenced by the climate, the seasons, and even its relations with foreign lands. However, external factors only manifest as a disturbance if there is already a vulnerability within the nation. If the internal state is perfect, the country remains unshakable.

The integrity of each city is guaranteed by the harmonious interplay of Ki and Ketu through the canals and dams. Therefore, an abnormality in the flow immediately impacts urban functions. Conversely, should a problem arise within a city itself, it will eventually ripple through the canals to affect neighboring cities.

When a problem strikes a city, the impact may be immediate or gradual. Immediate effects are often the result of Ki, which moves freely and rapidly, propagating the disturbance throughout the network. Once the function of a single city is compromised, it is inevitable that the disharmony will spread across the entire nation.

Once the function of a single city is compromised, it is inevitable that the disharmony will gradually ripple through the entire network to its neighbors.

【Key to the Allegory】

·       Ki = Qi

·       Ketu = Xue / Blood

·       Tubo = Acupoints

·       Canals = Meridians

·       Dams = Extraordinary Vessels

·       Cities = Zang-Fu

The Origin of the Allegory

The conceptual spark for my allegory, "The Story of a Country with Twelve Cities," came from reading "Warped Passages" by physicist Lisa Randall.

In that book, she allows the reader to glimpse the forefront of physics without ever using mathematical equations for technical explanations. Instead, she provides allegories to facilitate understanding.

This inspired me to create my own allegory. I felt that by following her example, I could present the complex theories of Oriental medicine in a way that clinicians can intuitively grasp and apply in practice.

正邪同一論(仮説)　
The Unity of Vital and Pathogenic Qi　
—"Non-duality of Vital and Pathogenic Qi" Theory —A Hypothesis　▼ For English,click here

「自動調整機能」の維持に重要な働きをしている気は一般的概念では正気と邪気が存在すると考えられています。しかし私自身は正気と邪気の区別はなく存在するのは気ひとつであると考えています。つまりその大過不及（多過ぎたり少な過ぎたり）によってその及ぼす影響が違うだけだと考えています。

具体的に言えば大過の時は気が多過ぎて正常に機能できず人体に不調和を起こします。このような状況にあるところの気を一般には別の物として邪気（実邪）と呼んでいますが元々は正気と呼ばれる気と何ら代わりのないものだと考えます。また不及の時も気が足りないだけなのですが足りないことで起こっている状況をあたかも何か特別の物が存在して起こしているように考えて虚性の邪などと区別したりしていますがこれも全く同じ気の現象のひとつだと考えます。

つまり一般に言う正気とは気が人体に都合の良いように働いている時の気の状態を指して言っていると考えます。したがって正気も邪気もどちらも全く同じ物でその人体への働きかけの違いによって呼び方を変えているだけと考えています。

これは、酸素を例にとって考えれば理解しやすいと思います。人間にとって酸素は生きていくうえで無くてはならないものですが高濃度の酸素を長時間吸うと肺を大きく損なってしまいます。人間にとってちょうど良い酸素の濃度は100％ではありません。多ければ多いほど良いというわけではないのです。また低酸素状態が長く続くのも危険です。気もこれと同じようなことが言えると私は考えているのです。

ところでここで論じてきた邪気は厳密に言えば内邪のことです。『内因なければ外邪入らず』という言葉がありますが、では内因とはどんなものかを一言でいえば『気の大過不及の状態が体内に起っている状態』を指します。つまり内因があれば元々それだけで病症を発現し易くなっているところに更に体内の気のバランスを崩すようなストレスが外から加わると病症も更に出易くなります。また既に在る病症は更に増悪する可能性が出てくるということになります。

バランスの崩し方は『更に大きく大過不及が進む』場合と『体内の気の総量が更に減少してしまう』場合と『その二つが同時に起こる』場合があります。

『内因なければ外邪入らず』というのは体内においても元々程度の差はあれ大過不及があったり気の総量が少なかったりすると外界の刺激によって更にバランスを崩し病症が出易くなるということであって、もし体内において大過不及がなかったり仮にあっても気の総量が十分あれば病症は出にくいということをあらわしています。

The Unity of Vital and Pathogenic Qi

—"Non-duality of Vital and Pathogenic Qi" Theory —A Hypothesis

In traditional concepts of Oriental medicine, "Qi" is often categorized into two opposing forces: Seiki (Correct/Vital Qi) and Jaki (Pathogenic/Evil Qi). However, I propose a different hypothesis: there is no distinction between the two.There is only one Qi.

The difference lies entirely in its distribution—specifically, its Excess (Daikyo) or Deficiency (Fukyu).

The Myth of "Evil" Qi

When Qi is overly concentrated, it exceeds the system's capacity to function, creating disharmony. We traditionally label this state "Pathogenic Qi" or "Real Evil" (Jitsu-ja), but in reality, it is the exact same substance as "Correct Qi."

Similarly, when Qi is deficient, the resulting symptoms are often treated as if a separate "deficient evil" exists. In truth, this is merely a phenomenon of insufficiency. "Correct Qi" is simply the term we use when Qi is functioning in a state that is optimal for the human body. The two are identical; they are only named differently based on how they affect our health at any given moment.

The Oxygen Paradox

Consider Oxygen. For humans, oxygen is indispensable for survival. Yet, breathing high-concentration oxygen for an extended period can cause severe damage to the lungs. The optimal concentration for a human is not 100%; "more" is not always "better." Conversely, a prolonged state of low oxygen is equally dangerous. I believe Qi operates on the exact same principle.

Internal Causes and External Stress

When we speak of "Evil Qi" in this context, we are strictly referring to Internal Pathogens (Nai-ja). There is a traditional saying: "External evils cannot enter if there is no internal cause."

But what is an "internal cause"? Quite simply, it is a state where Excess or Deficiency is already present within the body. When this internal imbalance exists, any external stress—environmental or emotional—further disrupts the equilibrium, making it far easier for symptoms to manifest or worsen.

The disruption occurs in three ways:

1. Exacerbation of the imbalance: Excess becomes greater, or deficiency becomes deeper.
2. Reduction of total volume: The overall amount of Ki in the system decreases.
3. Simultaneous occurrence: Both of the above happen at once.

The wisdom of "no internal cause, no external evil" means that if the body is free from excess or deficiency—or if the total volume of Qi is sufficient to maintain balance—the system remains resilient against external stimuli.

経穴ゲートスイッチ理論（仮説-本論）　　　　　▼ For English, click here

実は前述の件に関しては奇経に限らずそれぞれの十二経絡や臓腑や子午の関係に於いても同じようにゲート(交会している場所)の開閉によってその調和が成り立っていると考えて良いと思います｡

おそらく自動調整機能が働いている時はいくつかのゲートが自動的且つ適切に作動することで経絡や臓腑､奇経､子午などの調和を保つようになっていると考えられます｡そして経穴はそれらのゲートを体外から作動させることの出来るスイッチの役割をしていると考えられます。

したがって体が何らかの理由によって自動調整機能が正常に働かず調和を失ったときは調和を取り戻すために必要なゲートを開閉させることのできる経穴に鍼をすると良いはずです。

ただし､どの様に弁証するかによって同じ病症においてでも必要なスイッチ(経穴)の種類や数に違いが出てくることがあります｡例えば非常に緻密に弁証していけば場合によっては1箇所のスイッチ(経穴)によって寛解治癒することも可能性としてあります｡実際、臨床現場では偶然であったとしてもそういう場面(唯ひとつの経穴に刺鍼しただけで症状が消失した)を経験している臨床家も多いはずです｡しかしそれほどの結果をより高い確率で意図的に導き出せる臨床家となるとそれほど多くはないはずです。

　この様に経穴を｢自動調整機能(生体恒常性)の稼働のためのスイッチ｣だとすると治療はより高次のスイッチ(経穴)を選択することで｢影響のより大きいゲート｣や｢数多くのゲート｣をコントロールすることができます｡つまり少数のスイッチ(経穴)で寛解治癒に導けるはずなのです｡そしてそのスイッチ(治療穴)の選択法としてこれまで様々な弁証法や理論が考え出されてきました｡特に様々な理論を包括している経絡治療や中医学などは現在最も高次のスイッチを選択する方法論(弁証法)としては優れていると思います｡しかし自動調整機能はそれらの理論によって機能しているのではなくそれらの理論は自動調整機能を統計的に後付けで説明しているだけに過ぎませんから唯一絶対的な弁証法というものはありません｡したがって臨床現場に立つ者は複数の弁証理論を組み合わせて最適な治療穴を見つけ出すことが大切です。

ここで私の考える経穴ゲートスイッチ理論（仮説）による経穴の特徴について列挙してみます。

The Acupoint Gate-Switch Theory (Hypothesis: Main Thesis)

In fact, regarding the mechanism mentioned earlier, it is reasonable to consider that harmony is maintained through the opening and closing of "Gates" (intersection points) not only in the Extraordinary Meridians but also in the relationships between the Twelve Primary Meridians, the Zang-fu organs, and the Ziwu (Midday-Midnight) cycles.

When the body's auto-regulatory function is working properly, several gates likely operate automatically and appropriately to maintain harmony among the meridians, organs, and various systems. Acupoints, in this context, are thought to function as "Switches" that can operate these gates from outside the body.

Therefore, when the body loses its harmony because the auto-regulatory function fails for some reason, one should needle the acupoints that can open or close the gates necessary to restore that balance.

However, depending on the method of "Differentiation of Syndromes" (diagnosis), the types and number of required switches (acupoints) may vary even for the same condition. For example, if a very precise differentiation is made, it is possible that a single switch (acupoint) can lead to remission or a cure. In clinical practice, many practitioners have experienced moments—even if by chance—where symptoms disappeared after needling just one acupoint. Yet, there are not many who can intentionally produce such results with a high degree of probability.

If we define acupoints as "switches for activating the auto-regulatory function (homeostasis)," treatment can control "gates with greater influence" or "a larger number of gates" by selecting higher-order switches. In other words, it should be possible to lead a patient to remission or a cure with a small number of switches. To select these switches (treatment points), various methodologies and theories have been devised over time. In particular, Meridian Therapy and Traditional Chinese Medicine (TCM), which encompass various theories, are currently excellent as methodologies for selecting higher-order switches. However, the auto-regulatory function does not operate because of these theories; rather, these theories merely provide post hoc statistical explanations for the function. Therefore, there is no single, absolute method of differentiation. It is crucial for practitioners to combine multiple theories to find the optimal treatment points.

Here are the characteristics of acupoints based on my "Acupoint Gate-Switch Theory":

1. The number of gates operated by a single switch varies depending on the switch itself. Furthermore, the number of gates activated by the same switch can change as the situation changes. 

Commentary: We often select the same acupoint for different conditions. Also, even for the same patient with the same condition, we frequently experience differences in the level of effectiveness on different days, even when using the same combination of points.

2. There is a hierarchy among switches suitable for treatment. A higher-order switch can be expected to have an effect equal to or greater than multiple switches working simultaneously. Therefore, for effective treatment, one should choose switches for gates with greater influence or those capable of activating more gates. 

Commentary: This is precisely why so many methods of differentiation exist.

3. Combining several acupoints can sometimes produce a greater effect than using them individually. 

Commentary:This applies to the interpretation of the 69th Difficulty of the Nan-jing, "if there is deficiency, tonify the mother." An example is attempting to increase the therapeutic effect by selecting the Source (Yuan) point of the mother meridian in addition to the Source point of the affected meridian.

Note: As is well known, many practitioners can produce effects beyond the dimension of point selection through their needling technique. Therefore, even if treatments are based on the same theory or use the same points, differences in effectiveness often occur. In this case, needling technique refers to "how accurately one can advance the needle into the point" and "how significantly one can move the Qi."

Furthermore, if a patient has an absolute deficiency in the fundamental volume of Qi and Blood, controlling the gates alone will not allow the auto-regulatory function to manifest fully. Even if you place a ship in a canal with no water, the ship will not move. It is necessary to supplement the absolute deficiency through herbal medicine or diet. Acupuncture and moxibustion can be used concurrently to stimulate appetite and improve digestion, but the dosage of treatment should be the minimum required; one must be careful not to overdo it in haste. Over the long term, dietary discipline and exercise become essential alongside acupuncture.

On the next page, I will list representative switches in a table. While it is good to select points from this list based on various established methods of differentiation, I believe the final judgment depends heavily on the individual practitioner's intuition and experience. One must never neglect post-treatment reflection on the points selected. Therefore, interviews with the patient should be conducted carefully every time, not just at the first visit. Through the continuation of this process, the intuition for which acupoint to choose should become sharper.

"The 69th Difficulty says: The classics state, if there is deficiency, tonify it; if there is excess, drain it. If there is neither deficiency nor excess, treat the meridian itself. What does this mean? It means: if there is deficiency, tonify the mother; if there is excess, drain the child. One should first tonify and then drain. To 'treat the meridian itself when there is neither deficiency nor excess' means that the primary meridian itself has generated the illness without being affected by external pathogens. In such a case, one should treat that meridian itself; hence it is said, treat it by the meridian."

 ▼ For English, click here

十二正経と奇経と経穴の関係

この気血調和のメカニズムを経絡と奇経の関係から考察してみるとその関係は難経では｢十二正経の他に奇経八脈があり十二正経の流通の不調和が生じた時､仮に十二正経自らの調整能力によって調和が図れなかった場合､その調和を図るために奇経八脈が機能する。　つまり常に循環している十二正経の何れかに流通の不調和が生じ自らの調整能力によって調和が図れなかった場合｡具体的に言えば正経本流が氾逸するほど栄気が溢れかえっている時はその有り余った栄気を奇経に導き入れて本流を正常に戻し､逆に本流の栄気に虚損があればそれを補うべく奇経の何れかより栄気を補充して十二正経の不調和を調整する｣とあります。

二十七の難に曰く、脈に奇経八脈と云うもの有って十二経に拘らざるは何ぞや｡しかるなり、陽維有り、陰維有り、陽蹻（キョウ）有り、陰蹻（キョウ）有り、衝有り､督有り､任有り、帯の脈有り、凡そ此の八脈は皆経に拘らず､故に奇経八脈と曰う。経に十二有り、絡に十五有り、凡て二十七気相随って上下す､何んぞ独り経に拘らざるや｡しかるなり、聖人溝渠を図り設け､水道を通利してもって不然に備う、雨降下すれば溝渠も溢満す､此の時に当ってﾎｳ霈(ﾊｲ)妄りに作る､聖人も復た図ること能わず｡此の絡脈満溢すれば諸経も復た拘ること能わざるなり。

さてこれを治水･利水を目的とした運河やダムに例えて考えてみるとより解りやすいと思います｡つまりその性格上､経絡を河川や運河､奇経をダムや調整湖､それぞれが交会しているところを流水量･貯水量を調整する為の水門や可動堰に例えると、河川や運河(経絡)の水(気血)が溢れそうになれば水門(経絡が交会しているところ)が働いて調整湖(奇経)に導き入れて氾溢することを防ぐことが出来るし逆に不足があれば足すことも出来ると言うことになります。
したがって交会するところには治水の為の水門(ゲート)の働きが存在するはずです｡そう考えると治療穴というのはこの時水門を開閉する操作スイッチにあたります｡水門の操作は水門その場で行われる場合もあれば遠隔で行われる場合もあるのと同様に治療に於いても自経の交会穴以外で遠隔の経穴を選択することも出来ます｡実際には巨刺､繆刺､奇経治療､子午治療､経絡治療、経筋治療などのように病症の部位から離れた遠隔の経穴を選択するほうがよりよい効果を期待できる場合も多いのです。


例えば奇経治療においては八総穴がその水門(ゲート)を稼働させるためのスイッチであると考えることが出来ます。しかし八総穴に限ってゲートを稼働できるのではなく奇経に所属する他の経穴や交会穴･五行穴･郄（ゲキ）穴･絡穴･募穴･兪穴または場合によっては阿是穴などもスイッチの役割を果たす場合があると考えて良いと思います。そしてこれらの名称によってそれぞれのスイッチの作用の特徴を分類しているとも言えます。


例えば井穴は経脈の出るところ(心下満)、栄穴は経脈の流れるところ(身熱)、兪穴は経脈の注ぐところ(体重節痛)、原穴は臓腑の疾患に用いる、経穴は経脈の行くところ(喘咳寒熟)、合穴は経脈の入るところ(逆気而泄)、郄（ゲキ）穴は急性疾患に反応が現れる、絡穴は邪気実する時｡腑の疾患殊に慢性疾患に効果がある、募穴は経気の多く集まるところに在る陽病に効く、背部兪穴は陰病に効くと言う具合にです｡そしてこれらのスイッチの特徴を考慮して選穴すればより少ない経穴数でより高い効果を期待することができるはずです。その他には八会穴、四総穴などがありますし歴代の著名な医家が挙げる特効穴なども無視できません｡またそれぞれの経穴個々の性質(穴性)も参考になります。

Relationship between the Twelve Primary Meridians, Extraordinary Meridians, and Acupoints

When we consider the mechanism of harmony between Qi and Blood through the relationship between the Twelve Primary Meridians and the Extraordinary Meridians, we find a clear explanation in the Nan-jing (The Classic of Difficult Issues). It states:

"In addition to the Twelve Primary Meridians, there are the Eight Extraordinary Meridians. When disharmony occurs in the flow of the Twelve Primary Meridians, and if harmony cannot be achieved through the self-regulatory capacity of those primary meridians, the Eight Extraordinary Meridians function to restore balance. Specifically, if the 'Ying Qi' (Nutritive Qi) overflows to the point of flooding the main stream of the primary meridians, this excess Qi is diverted into the Extraordinary Meridians to return the main stream to normal. Conversely, if there is a deficiency in the Ying Qi of the main stream, it is replenished from one of the Extraordinary Meridians to adjust the disharmony."

The 27th Difficulty of the Nan-jing says: "It is said that in the pulse, there are the Eight Extraordinary Meridians which are not constrained by the Twelve Meridians. Why is this? It is because there are the Yang Wei, Yin Wei, Yang Qiao, Yin Qiao, Chong, Du, Ren, and Dai vessels. These eight vessels are not bound by the primary meridians; hence they are called the Eight Extraordinary Meridians. There are twelve meridians and fifteen collaterals (Luo), making twenty-seven Qi that follow one another up and down. Why then are these eight alone not bound? It is like a sage who designs ditches and canals to facilitate the passage of water and prepare for the unexpected. When the rains fall and the ditches overflow, causing a sudden deluge, even the sage can no longer manage it. When these collaterals overflow, the various primary meridians can no longer constrain them."

This concept is easier to understand if we compare it to canals and dams designed for flood control and water utilization. Due to their characteristics, we can liken the Meridians to rivers or canals, and the Extraordinary Meridians to dams or regulating lakes. The points where they intersect (confluence points) can be compared to water gates or movable weirs that adjust the flow and storage volume.

When the water (Qi and Blood) in the rivers (Meridians) is about to overflow, the water gates (confluence points) work to guide it into the regulating lakes (Extraordinary Meridians), preventing a flood. Conversely, if there is a shortage, water can be added. Therefore, at these points of intersection, there must exist the function of a "Gate" for water control. In this view, a treatment point (Acupoint) acts as the "Operation Switch" to open and close these gates. Just as a water gate can be operated either on-site or remotely, in treatment, we can select remote acupoints other than the confluence points of the meridian being treated. In actual clinical practice, such as in Ju-ci (opposing needling), Miu-ci, Extraordinary Meridian therapy, Ziwu therapy, Meridian therapy, or Jing-jin (sinew meridian) therapy, selecting a remote acupoint far from the site of the symptoms often yields better results.

For example, in Extraordinary Meridian therapy, the Eight Confluence Points (Eight Master Points) can be considered the switches that activate those gates. However, it is not only these eight points that can operate the gates. Other points belonging to the Extraordinary Meridians, as well as intersection points, Five-Element points, Xi-Cleft points, Luo-Connecting points, Front-Mu points, Back-Shu points, and in some cases, A-shi points, can also be thought of as playing the role of switches. It can be said that the names of these points classify the specific characteristics of their switching actions.

For instance:

• Well (Jing) points: Where the meridian Qi exits (fullness below the heart).

• Spring (Ying) points: Where the meridian Qi flows (fever).

• Stream (Shu) points: Where the meridian Qi pours (heaviness and joint pain).

• Source (Yuan) points: Used for diseases of the Zang-fu organs.

• River (Jing) points: Where the meridian Qi passes (cough and chills/fever).

• Sea (He) points: Where the meridian Qi enters (rebellious Qi and diarrhea).

• Xi-Cleft points: Where reactions appear in acute diseases.

• Luo-Connecting points: Used when pathogenic Qi is excess; effective for diseases of the Fu organs, especially chronic ones.

• Front-Mu points: Located where Meridian Qi gathers; effective for Yang diseases.

• Back-Shu points: Effective for Yin diseases.

By selecting points while considering these switching characteristics, it should be possible to expect higher effects with a smaller number of acupoints. Additionally, there are the Eight Influential Points (Eight Meeting Points), the Four Command Points, and the specific effective points identified by famous historical physicians, which cannot be ignored. The individual properties (point nature) of each acupoint are also useful references.

This is the essence of why the "Acupoint Gate-Switch Theory" (Hypothesis) is proposed.