The primo vascular system (PVS) was first introduced by Bong-Han Kim via his five research reports. Among these the third report was most extensive and conclusive in terms of the PVS anatomy and physiology relating to the acupuncture meridians. His study results, unfortunately, were not reproduced by other scientists because he did not describe the materials and methods in detail. In 2002, a research team in Seoul National University reinitiated the PVS research, confirmed the existence of PVS in various organs, and discovered new characteristics of PVS. Two important examples are as follows: PVS was found in the adipose tissue and around cancer tissues. In parallel to these new findings, new methods for observing and identifying PVS were developed. Studies on the cell and material content inside the PVS, including the immune function cells and stem cells, are being progressed. In this review, Bong-Han Kim’s study results in his third report are summarized, and the new results after him are briefly reviewed. In the last section, the obstacles in finding the PVS in the skin as an anatomical structure of acupuncture meridian are discussed.
1. Introduction: A Brief Historical Review
It was in 1962 when Bong-Han Kim (hereafter BH Kim or Kim) reported his first study results on the anatomical entity of acupuncture meridians (AM) [1]. He then established and became the director of National Acupuncture Meridian Research Institute in 1963 in Pyungyang, North Korea. The Institute produced four additional reports on this new system [2–5] until October 1965, when the institute abruptly closed for some unknown reasons. His fate after the event is still unknown.
The first report was very brief and mostly about the electric response of acupoints, which was probably not con- sidered very exciting. The second report, however, contains the discovery of a completely new system, constituting node- like anatomical structures at the acupoints and the tube- like structure (Kim claimed it to be the AM) connected to the nodes in the skin [2]. The research team named the nodes the Bonghan corpuscles (currently renamed as primo nodes) and the tubes the Bonghan ducts (primo vessels).
They also found that this new system existed not only in the skin but also throughout the body, including on the surfaces of body organs and inside the blood and lymph vessels. This new discovery became the foundation of the Bong-Han theory. To publicize its scientific achievements, the North Korean government translated Kim’s second report in various languages including English and disseminated it to most major libraries in the world [6]. The third report was an extension of the second one, observing the entire network of the Bong-Han system (renamed as primo vascular system (PVS)) in the mammalian body [3]. The fourth one was about the “Sanal,” (renamed to be Primo-microcell (P- microcell)), whose functions, he claimed, were regeneration and/or repair, as totipotent stem cells [4]. Sanal is a Korean word and its direct translation in English is “live egg.” The last (fifth) one was a brief report about the hematopoietic function of the Sanal [5]. These five publications were reports rather than journal articles, and they described mainly results with insufficient information on methods and materials. The introduction and discussion sections were very short.
Shortly after Kim’s fifth report, neither he nor his pub- lications reappeared in public for some unknown reason, and his work was completely neglected by the North Korean government. Outside the North Korea (Democratic People’s Republic of Korea; DPRK), there have been several attempts to reproduce Kim’s results but without success, probably because details of his methods to identify this new organ were described either in any of his reports or elsewhere. Nevertheless, until now, there has been no known seri- ous attempts to either confirm or negate his claims, with exceptions of the following two cases: one was by Kellner, who thoroughly investigated the acupoints in a histological manner but failed to find the structure that Kim had claimed [7]. In our scientific opinion, Kellner’s conventional method for histological study was not appropriate for detecting the anticipated structure in the skin, because in the cross section of the tissue containing an acupoint this new organ may not be differentiated from its surrounding tissues. Optically and histologically, both look very similar if they are seen in their cross sections. Its presence can be revealed most likely in the longitudinal view, with application of appropriate dyes, according to our own experiences for the past ten years. Another case was by Fujiwara and Yu, who partially confirmed Kim’s discovery but incompletely [8]. Fujiwara, who was an assistant professor in anatomy, then, later recalled that it took about a half year of hard work to get some positive results [9]. He was able to reproduce Kim’s results inside blood vessels and on the surfaces of organs, which eventually helped the research of Soh, one of the coauthors for this paper.
Soh was a professor in the Department of Physics at the Seoul National University (SNU) during 1976–2011. He formed Biomedical Physics Laboratory in 2000, initially to investigate the biological phenomena related to the acupunc- ture therapy using physical means, such as electricity, mag- netism, acoustics, and optics. He realized that his inves- tigation without anatomical bases would not lead to the fundamental mechanism behind the acupuncture therapy. Therefore he formed a scientific team to investigate the Bong-Han theory with Dr. BC Lee as the main experimental partner. The SNU team soon successfully confirmed the PVS presence inside the blood vessel of rabbits. However, this initial success soon faced difficulties in reproducibility. They realized that the research requires highly skilful researcher in microsurgery and optical imaging due to the extremely small size and the semitransparent nature of the organ, which frequently impeded the progress in their study.
The team, therefore, decided to seek Professor Fujiwara’s help and Soh visited Dr. Fujiwara in Osaka. Fujiwara him- self had experiences with failures in finding the PVS on the surfaces of internal organs for more than six months. Fujiwara was so kind to provide a movie containing the experimental procedures that he had developed in 1960s. With Dr. Fujiwara’s method, the SNU team then was able to reproduce his results. Since then, the team identified the PVS floating on the surfaces of intestines, liver, stomach, and bladder of rabbits. Soon, more thorough, histological and morphological studies on PVS were performed to confirm Kim’s claims. With techniques and experiences obtained for the organ-surface PVS, the team moved forward to find
the PVS floating inside lymph vessels. More importantly, a technique of using Trypan blue for PVS identification was developed by Dr. BC Lee, which enabled the team to identify the PVS in other organs, such as in the bovine heart, abdominal adipose tissues, brain ventricles, and the central canal of spinal cords. The Trypan blue technique also led to the discovery of the unique characteristics of the PVS in/on cancerous tumors (cancer PVS). This may probably be one of the most significant findings in the medical science because cancer is one of the most serious, life-threatening diseases.
Until 2008, the SNU-team was the only one performing the PVS research and, therefore, the research progress was rather slow. In 2009, a review article, written by Soh, cov- ering the PVS research progress during 2002 and 2008 was published in the Journal of Acupuncture Meridian Studies [10]. Since then several research teams in Korea participated in the PVS research, and the number of teams and their research subjects have been steadily growing. Outside Korea, the PVS gained interest as a research topic, mainly in China and USA. In September 2010, an international symposium on the PVS, The Primo Vascular System, Its Role in Cancer and Regeneration, was held in Korea, and its proceedings was published by the Springer Publishing Company in 2011 [11].
Recently, a research team led by BS Kwon at the National Cancer Center of Korea [12] confirmed that the PVS was abundant with immune cells such as macrophages and mast cells, which had been previously noticed by the SNU team [13]. In addition, primo nodes were also found to be packed with very small, embryonic stem cell- like cells. These data are consistent with the claims by BH Kim’s on the properties of the PVS on regeneration and wound healing [4].
In the remaining part of the paper, we summarize the content of Kim’s third report, which relates the AM system with the PVS, with our comments. His report contents are compared with the recent works reported by the SNU group and other PVS scientists. Kim’s study results that were scientifically verified by the PVS researchers were described first, and then new discoveries on the PVS after Kim were introduced. The desired directions for the future PVS research were also discussed.
2. Acupuncture Meridian System
The title of Kim’s third report is “The Kyungrak (經絡) System” [3], and it is officially submitted by the “Kyungrak Institute (經絡 研究院) of Democratic People’s Republic of Korea,” where Kim was the director. The English translation of the title is “Acupuncture Meridian System.” The report covers research results on the PVS network, and the scientific standard of its content is more advanced and comprehensive than that of his previous two reports. This was, in fact, his last report relating the acupuncture meridians with the PVS. The last two of his reports were about the “Sanals” or P-microcells [4, 5], and they were published shortly before the institute was abruptly closed in 1965.
The English translated table of content of the third report was presented in Box 1 for the readers to easily capture the breadth of Kim’s work. As can be seen in the box, the third report covers not only anatomical and histological aspects of PVS but also its basic physiological aspects. The conclusion section of the report is in fact a good summary of the report, which was highly beneficial to future PVS researchers. We, therefore, translated this section (pages 36–38 of Kim’s third report) with our own scientific comments, although the section by itself was already published in the book The Primo Vascular System [14]. We also added some of the important scientific progresses in the field of PVS, since Kim’s publications, in subsequent sections.
2.1. English Translation of Conclusion Section of Bong-Han Kim’s Third Report with Authors’ Comments
2.1.1. The Bong-Han System (BHS) Is Composed of Several Subsystems
(A) These subsystems have common properties of possessing Bonghan ducts (BHDs) and Bonghan corpuscles (BHCs). All BHCs are interconnected via BHDs. BHDs connect BHCs. A BHD is composed of one to tens of Bonghan ductules.
(1) A ductule has a thin layer, composed of endothelial cells with rod-shaped nuclei. It is surrounded by an external membrane (endo- BHD), which is made of smooth muscle-like cells and fine argentaffin fibers. (Comments: Kwon et al. observed epithelial cells rather than smooth muscle-like cells [12].) The interluminal space in a BHD is filled with fibrous and amor- phous materials. These ductules are wrapped together with a membrane (peri-BHD) to form a single BHD. This outer membrane is made of membranous cells. In the lumen of a ductule, basophilic the granules and nucleus-like bodies are present.
(2) The BHC is essentially formed by the enlargement, branching, or merging of the ductule. Also, the basic compositions of the BHC are the outer membrane of the ductules and the reticular fibers, extracellular matrices (ECM) between ductules. Inside the lumen of the BHD, which is extended from the BHC, basophilic granules, cell components, and chro- maffin granules are present.
(B) The BHS is classified as described in the following.
(1) Intravascular BHS. This BHS class consists of the intravascular (IV) BHDs and BHCs. It is systematically distributed inside blood and lymphatic vessels along the vessel and inside the heart. (Comments: Up to now, the authors observed that the BHS is only in large caliber blood or lymphatic vessels. In the BH Kim’s report, the size of the BHS-containing vessels is not clearly described.) The BHDs in this class are very fragile, and the ECM and their outer
membranes (epi-BHD) are not well developed. The IV-BHC has a structure, particularly similar to hematopoietic organs. In the reticular BHS, lymphocyte series and myelocyte-like cells (cells in bone marrow) are present. Sometimes cells similar to organ parenchyma cells are gathered around.
(2) Organ surface BHS. This class of the BHS consists of the organ surface (OS) BHDs and BHCs. They freely float on the surfaces of inter- nal organs and are not associated with blood or lymphatic vessels. For this class BHDs, the interluminal materials and the outer membrane are developed better than those for the IV-BHS. In the lumens of the BHDs and inside BHCs, there are cells possessing bright cytoplasm as well as the basophilic granules.
(3) Extravascular BHS. This BHS class made of the extravascular (EV) BHDs and BHCs. This runs along the blood and lymphatic vessels, and nerves. It is located just outside of them. It is covered with thick connective tissues. In the lumens of the BHDs and inside the BHC, many chromaffin granules are present.
(4) Nervous BHS. This class BHS is composed of the nervous (N) BHDs and BHCs, and it floats in the cerebrospinal fluid. Its branches are distributed in the parenchyma of the central nervous system and in the peripheral nervous system.
(5) Intraorgan BHS. Inside the parenchyma of internal organs, there are intraorgan (IO) BHDs and BHCs, terminal BHDs, and terminal BHCs. (Comment: the terminal BHD has only a single lumen, and it is a type of the ductule.) These are extension of the BHDs originated from IV-, EV-, or N-BHDs and present inside of the organ. Individual BHDs merge together in an IO-BHC and eventually form terminal sub-BHDs. These individual terminal sub-BHDs are directly con- nected to each nucleus of the organ cells. Again, these fine ductules come out from these cells.
(Comment: In summary, there are five subsystems, namely, IV-, OS-, EV-, N-, and IO-BHS). The BHS subclasses are well connected to each other. The IV- BHS is connected to the OS-BHS after coming out of the vessel wall. It is also connected to the EV-BHS via the EV-BHC. The OS-BHS is connected to the EV- BHS and the N-BHS. The communication among BHS subclasses is well established.
2.1.2. The BHS Is Made of Multiple Systems Circulating Bong- han Liquor
(A) Biochemical compositions of Bonghan liquor (i.e., liquid flowing inside the PVS) are
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(1) abundant in DNA and RNA;
(2) total nitrogen content is 3.12–3.40%. Non
protein nitrogen content is 0.10–0.17%. Lipid is 0.57–1.00%. Reduced sugar is 0.10–0.12%;
(3) total hyaluronic acid is 170.4 mg%;
(4) more than 19 free amino acids are present including several essential amino acids;
(5) there are more than 16 free mono nucleotides.
(B) The BHS possesses bioelectrical activities and mechanical motion.
(1) The propagation speed of the electric response from the BHD is very low and is similar to the two types of waves (E and F) displayed by the BHC. The BHD responses to electric stimuli appear in various forms. (Com- ment: there were two types of wave forms that Kim found: E and F; these symbols are Korean alphabet letters.)
(2) When a BHD is stimulated bioelectric sig- nals propagate through the BHD. The speed of propagation is faster (1–3 mm/sec) for the waves with a smaller amplitude and slower for the greater.
(3) The BHD has a spontaneous motion. This motion propagates and changes when the BHD is stimulated. Its longitudinal, os-cillatory motion is either continuous or periodic. The transversal motion is vibratory. These suggest that the BHS is capable of actively circulating the Bonghan liquor.
(C) All cells are connected to the BHS.
(1) The nucleus of each cell has very small, entering and exiting terminal ductules. These ductules are connected to the BHCs in the inter- nal organs. These IO-BHSs are connected to the cells only in their neighboring area. The IO- BHC is connected to the BHS of other classes. In other words, the BHS networks in various classes leave from and arrive at IO-BHSs.
(D) The circulatory paths observed by the radioactive
32 P injected into various points of the BHS are as follows.
(1) The Bonghan liquor from all tissues circu- lates to the BHS in the skin. (Comment: The BNS in the skin may be the known acupoints and probably many unknown points.)
(2) The Bonghan liquor flows from the BHS in the skin to the BHS deep inside the body.
The fluid in the deep BHS flows to the IO-BHSs and then to the cells in the tissue. These data
agree with the circulation study results obtained using dyes.
(E) The BHS circulatory path is not a singular system.
Unlike the blood circulation system, the Bonghan liquor circulatory path is not singular but multiple. These paths are connected but independent.
A dye or isotope injected into a specific network circulates only in the region of its particular network.
However, the Bonghan liquor in a particular path crosses to another one through the con- necting routes between the two paths.
2.1.3. A Change in the Bonghan Liquor Condition Affects the Functions of Organs
(A) Stimulation on the BHD affects the pulsation frequency and amplitude of the heart and changes the peristaltic motion of intestines. It also affects the hysteric curves of skeletal muscles significantly.
(B) Severing a BHD significantly affects the cells of the tissues connected to the BHD.
(1) It causes the dissolution of the nuclei and consequently death of the cells.
(2) If the BHD responsible for a peripheral nerve is severed, the excitability of the nerves reduces significantly.
(3) If the BHD of a motor nerve is severed, for a certain period of time, the associated muscle does not show movement responding to the repetitive stimulations.
2.1.4. In Terms of the Stage during the Differentiation and Development. The BHS Precede Those of Blood Vessels, Nerves, andOtherOrgans. ThetypicaldevelopmentalstagesofBHD, for chicken egg, from incubation are: the 7–8th hours, BHD blast; the 10th hours, pre-BHD; the 15th hours, proto-BHD; and the 20–28th hours, fully developed BHD. The earlier timeline of the BHS differentiation and development suggests its roles in the development. (Comments: in the report, there is no description on its roles.)
2.1.5. BHS Exists Broadly, in All Levels of Life. The BHS is proven to exist not only in the mammalian but also in all vertebrates and invertebrates. It exists even in the plant. We conjecture that it exists in any multicellular lives
The study results on the BHS suggest that the BHS circulation rout is cells in the tissue → skin BHCs → deep BHCs → intraorgan BHCs → terminal BHSs → cells in the tissue.
The BHS is made of multiple, independent circulating systems (subsystems), which are interconnected each other, but forming a single coherent system.
All organs of the living beings are connected to and controlled by the BHS. In other words, all forms of lives have their own BHS.
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Review Article
50 Years of Bong-Han Theory and 10 Years of Primo Vascular System
Kwang-Sup Soh,1 Kyung A. Kang,2 and Yeon Hee Ryu3
1 Nano Primo Research Center, Advanced Institute of Convergence Technology, Seoul National University, Suwon 443-270, Republic of Korea
2 Departments of Chemical Engineering, University of Louisville, Louisville, KY 40292, USA 3 Korea Institute of Oriental Medicine, Daejon 305-811, Republic of Korea
