Chinese Medicine is an extensive medical modality that has existed for thousands of years, and is the product of a vast history of oral tradition and written commentary from hundreds of medical practitioners. Developed over centuries these traditions birthed influential scholastic traditions that still inform the medicine today. Central to the Medicine are Primary texts based on these oral traditions. Most schools and practitioners, with proper education owe their heritage to a text called the Shang Han Lun which was an attempt by a figure named Zhang Zhong Jing, to standardize medical protocol, improve and ensure treatment efficacy, and to do away with medical practices that were either ineffective or had lost their cultural relevance. Zhang Zhong Jing was a government official who had little connection to medicine. However, when a pestilence plagued his region, he is said to have lost over two-hundred family members to the epidemic. He observed the way in which doctors struggled with offering effective care to large groups of people. He decided that he would collect from various provinces the knowledge of medical practitioners, and find the common threads and standardize these observations as basic treatment observation and protocols. The SHL is the first standardized treatise of Chinese Medical wisdom.
The Chinese are historically bound by offering consideration to and developing wisdom from their ancestry. ZZJ developed his wisdom through the consideration of prior prominent historical figures, one of whom being the legendary Huang Di. Huang Di is credited with inventing agriculture in China, and is credited developing the text Huang Di Nei Jing – the Yellow Emperor’s Classic. (100 B.C.E.). Researchers believe it is a compilation of oral traditions, similar to how the epic poetry of Homer is believed to be a group of oral narratives that were later standardized and written down. For context, writing became standardized in China only about a hundred years before during the Qing dynasty, 221-206 B.C.E. As we can see, agriculture, at least in China, was concurrent with the advent of a writing system.
This classic was born out of a larger movement of cultural observation and cultivation that emerged from the advent writing, which itself brought an emphasis on classification.
Classification itself, was the result of evolving consciousness from observation of the cycles and changes of the natural world. Agriculture brings consciousness to lifestyle modification, specifically how one worked to cultivate the landscape; how one’s environment changed perception, and how one’s perception changed environment.
These awarenesses developed consciousness around the phases affecting seasonal crop cultivation. From observation of natural change came:
- Idea of hot, cold, dampness, dryness.
- Idea of the body being affected by these factors. When the body is cold, there is constriction.
- Development of empirical knowledge through observation.
- Developing awareness of how to adapt to the environment.
Agriculture can be seen as a cultivation of a group of people to the earth. By first observing the effect cultivation has on the external environment, Chinese peoples developed knowledge regarding the way in which the external could influence the internal. Where cold and dryness could affect the constriction and decay of plants, a similar “doctrine of signatures” emerged regarding how similar processes happen within the body.
You may wonder: why, until recently, didn’t China develop in the same way as the West?
“The scientific and industrial revolutions did not occur in china, despite many advances prior to those of the West; one of the key reasons is that Chinese science and techonology always functioned within the philosophy that recognized the importance of balance and harmony between human being and the environment. The sciences of China never dreamed of divorcing science from ethics, but when at the scientific revolution, the final cause of Aristotle was done away with, and ethics chased out of science, in the west, things became more menacing.” (Ni, 2005, pg. xi).
China therefore refer to themselves as the descendants of Huang Di, who is the symbol of vital spirit of the Chinese revolution.
This text, the Huang Di Nei Jing is actually two works: the Su Wen– referred to as Questions of Organic and Fundamental Nature, and the Ling Shu– The Classic of Acupuncture—which refers to Acupuncture and moxibustion.
The Neijing, which is actually, in a translation a very quick read—is one of the most important classics of Daoism. Daoism is an attempt, a movement, during the advent of writing and overhauling classification, to return to or maintain a state of harmony with the movement of the environment and the nature of reality; which, basically, they believed is relative. Given the state of the advancement of technology, specifically in the exchange of information via text and visual image, this dialogue still holds especial potency today.
Chapt 1, the Dao De Jing says:
- The Tao that can be told is not the eternal Tao. The name that can be named is not the eternal name. The nameless in the beginning of heaven and earth. The named is the mother of ten thousand things. Ever desireless, one can see the mystery. Ever desiring, one can see the manifestations. These two spring from the same source, but differ in name. Darkness within darkness. The gate to all mystery.
As you can see, there was attempt by certain groups or movements, Daoism namely, and you can see this also in Buddhism and Confuscianism later, to resist schools of classification, objectification—as there was the belief that you really could not know yourself, your body, and how your body changes over time, without understanding the nature of change itself—which was readily seen and known in the changing environment.
There is a Daoist axiom that says without looking outside, one can know the workings of the world- this reflected the idea that the microcosm of the body was inseparable from world—and this continues to be an axiom of Chinese medicine. When we look at an individual’s life within the moment they come into the clinic, we are gauging how much a person’s life is affected by, and potentially, is a reflection of what is happening externally.
If we find there is a large discrepancy, say in what is happening outside, and what is happening within another, we are basically gauging an individual’s resistance or acceptance of change.
The Neijing as I’ve described is a Daoist classic which gives an holistic image of human life. It does not separate external changes–geographic, climatic and seasonal for instance, from internal changes such as emotions and our response to emotions.
The Neijing articulates a treasure of knowledge concerning the natural way to health, implying that all phenomena of the world stimulate, tonify, subdue or depress one’s natural life force. This holistic life philosophy the ancients developed represents the basic tent of the integral way—a life lived in harmony with the universal law. “Health and well-being can be achieved only by remaining centered in spirit, guarding against the squandering of energy, promoting the constant flow of qi and blood, maintaining harmonius balance of yin and yang, adapting to the changing seasonal and yearly macrocosmic influences, and nourishing one’s self preventatively. This is the way to a long and happy life.” (Ni, 2005).
Concept of “Qi” and “Yin and Yang”
Time and perspective led to extrapolate the more subtly perceptible changes influencing the state of the external world and internal body.
The concept of Qi, Yin and Yang—which are unique to the Chinese system-and have no analogue in Western medical thinking—provide significant contention in the dialogue between Eastern and Western medical perspectives. I believe this is due mostly to the historical tendency for the West to ignore not only the natural cycles and themes purported by the seasons, but also their significance and influence on our health and well-being.
In addition, the West tends to reject even the most basic principles of adapting to the changing seasons. We tend to rather live in temperature-controlled biospheres, sending the signal to the body that we are perpetually in the season of Summer. We tend to pretend that weather is of no consequence. It is not unironic that Western Medicine finds little use or necessity in training for nutrition for either practitioner or patient. Nutrition is literally the fruit of the natural and phenomenal processes, developed out of interdependent relationship among species. If our official stance is that we are invisible or superior to nature, it is not surprising to find lackluster attitudes toward the role of nourishment in wellbeing. Climate change is the logical inflammatory process that follows knowledge and cultivation of this interdependence.
Yin and Yang provide a primer to the most basic observation of difference and of juxtaposition. They provide a most basic scope for living, and it is based not in measurement, but relationship.
Despite having no immediate Western equivalent, from a scientific perspective (Scientific means simply not measured by the standard of Western scholastic conceptualization), Yin and Yang are not too difficult to comprehend; if anything, they are a spectrum ranging from what is most insubstantial—you could look at wind, clouds, light—to that which is more substantial, earth, water, trees.
- The Neijing chapter 5 says:
- In the universe, the pure yang qi ascends to converge and form heaven, while the turbid yin qi descends and condesnces to form the earth. Yin is passive and quiet, while the nature of yang is active and noisy. Yang is responsible for expanding and yin is responsible for contracting, becoming astringent and consolidating. Yang is the energy, the vital force, the potential, while yin is the substance, the foundation, the mother that gives rise to all this potential.
- This is not unlike how, say, an artist, an illustrator or painter experiences light. If you are an artist, this is apparent. You know that often when you are depicting an object, you know that you are not necessarily drawing the object itself—rather you are depicting how light hits that object and depicting the shadows created in this process, and the image is defined more as a combination of shapes created by the interaction of space and negative space. This is very much like yin and yang. In further study of Yin and Yang, that there is a spectrum that exists between what is most Yang, and what is most Yin. And even more, they are said to contain within them the seed of their opposite. This just goes to say that when you reach the height of Yang, it is that much more likely to transform into its opposite. Think of a guy who take a lot of steroids, Arnold Schwarzeneggar—over time, all that testosterone, all that Yang, will begin to resemble or transform into Yin—and what were once pectoral muscles—now resemble breasts.
There are substances or densities within the body that fall somewhere along this spectrum, and they maintain their density and conformation according to the nurtured integrity of the landscape.
Along this spectrum, what could be described as most Yang, the most insubstantial? This is what is referred to as “Qi”. Qi then is that motivating force that assists in moving the more yin substance, blood, flesh, connective tissues, fluid from their most dense states, to whatever state the biophysical process demands.
There was an article going around recently about Van Gogh and his paintings which depicted intricate swirling across the canvas. Recent observation has determined that somehow what Van Gogh was depicting was what is called “Turbulence” in modern western fluid physiology. It is defined as a flow regime characterized by chaotic property changes. Qi, which is the most Yang of Yang, which just means- most volatile, lightest, transformative and most insubstantial—like the wind–is said to move quickly and erratically, but in different forms within the spectrum—it moves in potentially more ordered or predictable ways. Through the process of observation, it is not difficult to consider these physiological concepts developed by the Chinese—which, may appear foreign to us, are nonetheless valid players in understanding the nature of reality, weather, and health and pathology.
Therefore, the Neijing offers a written compilation, extrapolation for the emerging times, perhaps as an attempt to counteract the advent of written systems- which, as we know—once something is written, it becomes subject to interpretation, and that interpretation is contingent on the bias of the translator. It is highly possible that given the emphasis Daoism has historically had on adaptability to change, they were equally cognizant of the effects of both agriculture and writing on the human mind. This book, the Neijing, is a testament to offering a primer to large scale cultural change that was imminent. It is still relevant even now.
Qi, therefore represents the capacity for an individual to gauge the nature of change. It exists on a spectrum, and changes according to the location of the body. This is a discussion that will be later discussed in the extrapolation of this blog. It is one of the most elusive aspects of this medical modality, but possibly the most important to comprehend, sense and understand. The goal of the medical practitioner is to cultivate ways to tune into this phenomenal subtlety. Acupuncture facilitates and fine-tunes these transformational states to match the body’s innate wisdom to adapt and heal.
Medicine in Crisis
I am attempting to offer such a primer to those who are interested in the alternative medical modality that is Chinese Medicine.
It is not difficult to see that modern medicine in the West is at a crossroads. Whether it is a simple doctor’s visit for a cold, prescription pharmaceuticals, or even an emergency trip via ambulance, the medical system often proves as impersonal, confusing, and more often than not financially unaffordable.
Chinese Medicine, is a medicine that has consistently evolved out of cultural and economical crisis, and this is evident in treatise upon treatise of medical observation, preserved in thousands of medical texts. Often, advancements of thought and treatment emerged from war.
Medicine by nature requires constant renewal. Resistance to novel ways of viewing ourselves, and comprehending what is healthy, body, mind and spirit, leads to physical and spiritual crises.
It is my contention that Chinese Medicine as a medical modality is a viable medical alternative given its emphasis on the individual. In the course of a medical intake, the CM practitioner uses various diagnostic skills to recognize not necessarily what is so objective factors of an individual’s life—but rather to assess the subjective nature of their disease process.
I am trained to observe and consider information about your individual life that does not fit a textbook diagnosis or a statistic. As a teacher once said, we are in some way looking to invalidate the system we use, which basically goes to say that we are looking for the part of an individual, the patient, that is unique—I use this to remind the patient the way in which they can shine, rather than the way in which they’ve burned out.
Like an artist sees light, as Western medical doctors use differential diagnosis—I am attempting to recognize, in essence, what you are and what you are not. This means that when I take your pulse, I am not simply gauging what a tight pulse feels like, according to a text, but rather how the pulse is tight in relationship to you.
If you are a 6 ft tall football player, and you come in and your pulse is very thin, with little body to the vessel, then I want to know what is causing this discrepancy. I would expect the pulse of an athlete to reflect their lifestyle and their identity: I would expect it to reflect you.
And thus, I have several modalities, within the scope of Chinese medicine, that I utilize to gauge within the spectrum of yin and yang, the phenomenon of qi—the expression of these processes as represented by the individual.
- Tongue Diagnosis
- Some use odor
- Ten questions- digestion, bowels, urination, sleep, energy, pain, sexual health, ENT.
Remember, all of these diagnostic tools are used to gauge an individual’s health both objectively and subjectely.
- Wow, their tongue is wide, but after seeing them for a while, I have discovered this is constitutional and does not reflect Spleen pathology.
Qi as spectrum of Density
Chinese medicine emphasizes and gauges how change occurs in nature, and as we have also discussed that change, that macrocosm, affects our bodies, our internal microcosm, and how we change according to the cycles of the seasons.
I also discussed that Qi represents a spectrum of density, and that depending on where that Qi is locationally within the body, it changes or transforms in density. This is not unlike certain landscapes, at certain times of day, moving from a mist in the morning, to a drier, clearer sunlit day further on.
Qi, is really about movement, animation in the body, and as I have expressed, it can be found in many different types of density within the body.
Over time, Chinese medicine has developed a highly-intricate and extensively studied understanding of how Qi manifests and moves within the human body. There are types of Qi that are more external, and circulate more on the exterior of the body—and as we have learned, Qi is referred to as the yang of yang. On the surface of the body, this would be seen as the most volatile and insubstantial form of qi. The deeper you move into the body, the more substantial the Qi becomes, the slower and more order its movement, likewise becomes.
As such, there are various systems that have been developed in the history of Chinese medicine that extrapolate the different densities and levels through which Qi travels. Qi functions as one’s ability to navigate the change that we experience in our lives on a day-to-day basis.
This leads us to the Primary Meridians utilized in the practice of acupuncture.