Article Text

other Versions

PDF

Book reviews
Muscles and meridians: the manipulation of shape
  1. David Mayor
  1. Correspondence to Mr David Mayor, Hon Research Fellow, Division of Physiotherapy, University of Hertfordshire, 86 Handside Lane, Welwyn Garden City, Herts AL8 6SJ, UK; davidmayor{at}welwynacupuncture.co.uk

Statistics from Altmetric.com

Edited by Phillip Beach. Published by Churchill Livingstone, Edinburgh, 2010. 223 pp, £34.99 (paperback). ISBN: 978-0-7020-3109-0.

‘There is no doubt that our body is a moulded river’ (Novalis, cited on p 125)

The author's themes

This is an unusual book, by an osteopath who went on to train in acupuncture but felt dissatisfied with the usual explanatory models of both treatments. Three primary themes weave their way through his writing: movement, archetypal postures and meridians.

As an osteopath, his focus remains biomechanical—on shape, posture and movement (or ‘coherent changing of shape’). In attempting to understand how the body moves in a holistic way, he has developed the conventional ‘muscle chains’ of osteopathy into what he calls ‘contractile fields’ (CFs), primary patterns of movement that span the whole body, as against the elements of movement or the different muscles in isolation (the ‘dissective paradigm’). Although he sees his CF model as only a starting point in mapping the muscle matrix, he also rather pretentiously describes it as ‘an idea whose time has come’.

The opposite of movement is rest. Beach describes what he believes are the archetypal postures of human life, used throughout our evolution (and certainly before the evolution of the chair), and emphasises the importance of incorporating ‘floor living’ and ‘erectorcise’ (rising from the floor) into our modern lifestyle if we are to remain posturally healthy.

The author's third theme is that of the traditional meridians of Chinese medicine, not as conduits for qi and blood or mere mnemonics for point location, but as ‘emergent lines of shape control’. He suggests that the CFs underlie the traditional meridians of acupuncture, and that the acupoints were derived from the ‘hand-holds’ of manual (manipulative) therapy, a somewhat puzzling suggestion given that they have never been taught in this way to acupuncturists—at least, not in any classical text or extant tradition that I know.

An outline of the book

His first two chapters concern the ‘body-plan’, how our anatomy has evolved phylogenetically and embryologically. They are detailed, complex and often difficult to follow, particularly as the language is unfamiliar and the illustrations not always well labelled (although this is more of a problem later in the book, for instance in chapter 10). The next chapter examines ideas of fields, systems theory and emergence, and provides an overview of the CFs, ‘rivers of contractility’ which flow and course though the body, most with their own ‘embedded’ sense organ (again, the tone is somewhat self-congratulatory—this embedding is considered ‘novel’ and ‘conceptually elegant’). There are six CFs:

  • Lateral (L)

  • Dorso/ventral (D/V)

  • Helical (H, emerging from the interaction of the D/V and L CFs)

  • Limb

  • Radial (R)

  • Chiralic (C),

  • together with a Fluid field (F-F).

The following seven chapters describe the CFs and the Fluid field in some detail. The L-CF covers the lateral border of head and torso and is concerned with side-bending, the D/V-CF manifests as ‘rings of bilateral, para-axial contractile tissue’, the H-CF concerns obliquely oriented muscles, the R-CF maintains core stability and the C-CF is modelled around the pulsatile and peristaltic movements of the viscera. The F-F ‘takes a wide-angle view of the primary fluid systems’ of the body, in echo of the quotation from Novalis above. It would probably be simpler to understand the CFs in a demonstration that uses tactile and kinaesthetic experience than through reading; trying to grapple with complex verbal descriptions of hypothetical invisible entities derived from hands-on working is not easy.

After 150 pages of arduous headwork, it is a relief to come down to earth in chapter 11, where Beach—without even a mention of the CFs—changes tack and describes nine archetypal postures and a series of ‘erectorcise’ exercises (also available at http://erectorcise.com), exhorting his readers to ‘free your feet from the sensory deprivation chambers’ (ie, shoes) and spend some time each day walking barefoot on an uneven surface (a ‘rock garden’ is proposed, particularly for those with poor balance). These measures he considers offer a ‘self-tuning mechanism’ for the body. I have found this the most useful chapter, both for myself and for patients, and have spent longer on the floor, comfortably (and by design, not accident), than I have for a long time, although I have not yet recommended a rock garden to anyone.…

Of most interest to readers of this journal will be the longest chapter in the book, ‘Decoding the Chinese meridial map’. I was looking forward to a grand synthesis here, but have to confess I was disappointed by Beach's reduction of the subtleties of the meridian system, so much of which is based on sensory awareness, to a dry mapping of movement patterns of recoil from a noxious stimulus. In his dissatisfaction with traditional theory, he has eliminated qi energetics and a receptive listening to the body in favour of biomechanics, possibly with the addition of insights from the more forceful martial arts (very much a doing to the patient). Although he acknowledges (p 183) that the meridial web has had many weavers, and that the CF model should not be pushed too far (p 170), he does end up seeming to force things to fit his own views. For example (p 156), he makes an unreferenced and somewhat sweeping statement to the effect that ‘the Chinese’ suggest that babies do not have meridians before the age of 6, and then attributes this to the maturation of maps of the recoil reflex that he proposes are the basis of the meridians.

The final chapter in the book reviews what has been written so far, includes brief contributions from two of the author's associates and sketches some wider implications and future directions. He ends with two admirable sentences (p 198): ‘Less dogma, but more understanding is required. Our patients deserve nothing less’. Many medical acupuncturists would probably concur with his view that ‘layer on layer of needless dogma has obscured the manual roots of the profession’ (p 198), but whether those roots are the ones that he proposes is arguable.

On systems, thinking and language

I have never been comfortable with systems (dogmatic or otherwise) that proclaim themselves as fons et origo of everything one would ever want to understand, and whose creators at the same time make no attempt to examine the testable consequences of what they propose. It is unfortunate that Beach looks only at the way his theories ‘explain’ the meridial map (from which they are, in part, derived), and does not explicitly state any clinically testable hypotheses. One such would be his suggestion (p 122) that ‘rising from the floor 50–100 times a day will help self-regulate blood pressure’. It would not be difficult to organise a small study to test this idea, but in this respect Beach seems to be more of a thinker than a doer.

This is not an easy book to read. It is densely written, with the assumption that the reader can somehow get inside the author's head to unravel the complex pathways of his thinking. At the same time, perhaps in an attempt to make the content more accessible to the reader who is less of a thinking type, there are interpolations of language that comes straight out of Star Trek—warp speed, docking stations, spacecraft vernier jets—as well as some banal cartoons which really made me recoil (and probably affected my personal meridian map considerably in the process). Not being an osteopath, I also dislike mechanical metaphors, such as that of the body as a tunable car engine, for example (p 189), and the misspelling of ‘acupunture’ on the title page is deplorable.

Beach has spent many years pondering his system and its intricacies, creating the CFs on the basis of his own experience, endless thought experiments (suppositions, speculations, imaginings, wonderings, musings, interpretations, assumptions—to use his own words) and a considerable amount of associative rather than deductive thinking, but little external evidence or consideration for historical context. Whereas, like many original thinkers, he can probably no longer view his patients without applying his system automatically, I am not sure how useful it will be for most acupuncturists.

View Abstract

Footnotes

  • Competing interests DM is the co-editor of Energy Medicine East and West: a natural history of qi (Elsevier 2011), in which he favours the view that the mai, the precursors of the jingluo (or acupuncture meridian system), were developed in part ‘on the basis of subjective embodied experience of disordered or disturbed qi’ rather than external techniques such as bleeding.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.