Form and Formless Binding

In order to understand the concept of binding, one must first consider the fundamental yin-yang division in Chinese medicine of formed and formless.  Qi*, for example, is classified as formless right, while a tangible nodulation exemplifies an evil with form.  The terminology “with form” and “formless” is incorporated into Chinese anatomy and physiology and also is used in discussing right and evils.

Breast pathologies in females illustrate the idea of the formless binding with that which has form.  In some women, there may be breast distention prior to menstruation.  Distention, or 张 zhang, always indicates stagnation of qi;  specifically, in premenstrual breast distention, it is the liver qi which is depressed and bound.  If formless qi stagnation worsens, there may be fibrocystic breast disease, apparent in palpable masses which come and go.  The terminal stage, both in the sense of the last pattern to arise and in reference to its threat to life, can present with a hard, shell-like quality of the breast indicative of severe blood stasis.  At this point, a formless qi stagnation has now completely transformed into grossly hardened tissue.

Although binding reiterates the relationship between qi depression and the yin depressions described in the theory of the six depressions, it even more strongly emphasizes potential for formless depression or stagnation to develop into substantive blockage.  By including the term binding in the pattern name, the long lineage of Chinese doctors reminds us to consider the dynamic potential of mutually engendering patterns.  This perspective is indispensable for the successful treatment of real-life patients, who often present not just one, but as many as three to ten (or more) patterns simultaneously, requiring complex diagnoses for effective treatment.

*In the West, qi is often considered “energy”, but the Chinese historically did not conceive of a distinction between energy and matter.  Qi was actually considered to be formless and fine substance, too small to be seen.  The archaic character is simply comprised of three, curved lines representing ephemeral vapor rising from wet rice fields, suggesting a delicate mist of material substance rather than an invisible form of energy.