Why Traditional Chinese Medicine?
To invoke a biological metaphor, think of the two main modalities of TCM as if they were parts of the body. Acupuncture corresponds to the hands, as it treats conditions close-up, when the patient is “at hand,” as it were. Herbology, by contrast, corresponds to the feet, as the use of herbs is more “mobile,” allowing the portable practice of TCM; one can use herbs anywhere. The use of these two components, like the use of the hands and the feet, depends entirely on the proper functioning of the nervous system. From the base of the spine to the top of the skull, there is an elaborate network of nerves and synapses connecting all parts of the body. At the lower section of the spine, in the lumbar region, there are connections to the kidneys, bladder, and other lower abdominal organs. These organs, in the TCM system, correspond to the San Jiao, the upper, middle and lower “burners,” and, in the Wen bing xue, the transformations of Water and Fire are discussed as they relate to human disease.
In the Western view, the San Jiao (Water and Fire) corresponds to the functioning to the human endocrine and lymphatic systems, that is, to biological functions relating to fluid circulation and metabolism, thus showing once more that TCM proceeds by way of metaphor to describe and address the same conditions as Western medical science. The difference in underlying metaphysical assumptions and methods does not preclude their arriving at similar conclusions; TCM bears testimony to the truth of Western medical science, even as Western medical science bears testimony to the truth of TCM. Moving upward, we come next to the thoracic vertebrae, located in close proximity to the central organs (Heart, Lungs, Liver, etc.). These same organs, in their TCM presentation, are studied in and explained by, the scholarship of the Jin and Yuan Dynasty, commonly referred to as the Four Streams of Scholars. These scholars, and their works, address the relationship between the main organs of the body and the Five Elements of TCM. These scholars not only laid the foundations for much of the zhang fu diagnosis and treatments so common to TCM, but in fact elaborated once and for all the entire system. An understanding of even the most basic elements of TCM ( the concepts of zhang fu and Five Elements) is impossible without reference to these canonical works.
Proceeding further up the spine, we come to the cervical vertebrae and the skull. These sections correspond to the Shang han lun and the Jin kui yao lue, which are devoted to understanding and integrating the various aspects of TCM theories and practices. Paradoxical as it may sound, this integrative function precedes in time that which it integrates; Shang han lun and Jin kui yao lue were written before the other works referenced, and indeed the classics, on this model, are arranged in order of age, with the oldest works at the top and the most recent at the bottom of the spine. This apparent paradox is resolved by remembering that all subsequent scholars to the original canonical authors understood themselves to be developing or elaborating more completely the fundamental insights of the original master authors. The intellectual development of TCM is in this sense evolutionary, not revolutionary. This tri-partite division of the canonical texts of TCM represents the fullness of the tradition, encompassing the principles of Mastery (Shang han lun, Jin kui yao lue), Function (Jin and Yuan Dynasty scholarship), and Integration (Wen bing xue).
Using this model, we see that the proper functioning of any set of organs or systems, the treatment of which would be performed by the hands (acupuncture) or the feet (herbology) is a function of the proper order and arrangement of the various “spinal” elements of the tradition. Even as the hand cannot work, nor the foot move, if one of the vertebrae should be damaged, or the impulse from the brain be blocked, so, too, can acupuncture and herbology not achieve their results unless their practice is directly informed by, and integrated into the function of, the brain and the entire spinal column.
If I might be permitted to expand just a bit more on this theme, I have observed that the poorest “Oriental medicine” schools go only to the hands and the feet, providing a sort of “paint-by-numbers” approach to the practice of acupuncture and herbology. It is as if they attempt to derive hands and feet, acupuncture and herbs, from nothing, connected to nothing; theirs is an “amputated” and mutilated sort of practice. We may safely dismiss schools of this character from our consideration, as they practice a very hit and miss style, with poor integration of the elements of the discipline, achieving success as often by luck as by skill.
Slightly better are those schools and programs that provide some exposure to the lower two sections of our model’s spine; not nearly so superficial as the first category, they do provide some introduction to the basic elements of the theory behind the appropriate use of acupuncture and herbology; in this respect, they are somewhat better than the others. For them, the hands and feet are connected to the spinal column, but this column is separated from the skull and the brain. That is, they lack the principles of mastery. It is as if they were attempting to give life to a headless being; in principle, it could be done, but the result is wholly unsatisfactory, and the being in any event would not be considered “alive.” These schools are the vast majority here in the West, I fear, and theirs is a headless, mindless discipline in many ways.The best schools, into which category our school has always strived to belong, provide a complete and intact nervous system, corresponding to the proper functioning of the brain and its chemistry, to invoke once more the Western bio-medical model, fully integrating all aspects of TCM, with a view to the healthy and proper function of all the parts of the body in our model. Hands and feet are connected through the appropriate intermediaries, to the brain, and the whole functions as one. “Sanas,” the Latin term for health, can also be rendered as “wholeness,” and this idea has always informed all medical traditions, even the Western.
When a TCM practitioner speaks of “integrative medicine,” the simple inclusion of traditional Chinese theories and practices into the panoply of health care options is not what is meant. Rather, integrative medicine, as understood and practiced by TCM, is not only the expansion of the universe of medical practices, but also the integration of all aspects of all healing arts in the body of each patient. This sought-after physical unity is itself the biological expression of the fundamental ontological insight of the Chinese phenomenological system; this is the Five Elements as they really are, in the fullness of their being, and not, as is so often the case in the West, as a quaint piece of colorful medical folklore.
Consider a pure mountain spring, a small, cool trickle of the purest water. Though the flow is apparently limited, we can see that, a short distance from the spring, there flows a small stream, which itself feeds into a river, which, as it descends down the mountainside, empties into a deep lake.
The sight of the spring would not, in itself, suggest the strength of the river, nor the depth and breadth of the lake downstream; and yet, we find in the lake nothing which was not in the river, and we find in the river nothing which is not from the spring. This is case with the intellectual development of TCM: the spring of the Shang han lun cuts the channel for, and itself gives rise to, the river of the Jin and Yuan scholarship, which, as a mighty torrent of thought, issues finally in the wholeness of the Wen bing xue.
From the source, everything downstream draws its essence and even its existence; the character of the spring determines the qualities of the river and the lake. The river is an expansion and increase in the force of the qualities of the spring; the river quantifies, as it were, the qualities of the spring. These two elements, quality and quantity, find integration and reconciliation in the wholeness of the lake, which contains the qualities of the spring and the quantities of the river, without loss or diminution of either.Spring, river, and lake correspond, therefore, to the principles of Mastery, Function, and Integration, mentioned in our biological model.
The lake does not suggest the river, nor does the river suggest the spring, but the spring contains and directs the river and the lake. Knowing the canonical texts of TCM provides one with an integrated, living body of knowledge, flowing without cease from its pure sources, through its active channels, to the depths of its integration. And even as the spring does not dry up, the river does not cease its mighty flow, nor does the lake ever overflow; perfect harmony, perfect concord, perfect order.
I close with a simple story, a parable drawn from real life. When I first came to the United States, I was surprised to find Chinese restaurants everywhere I went. And while the food was, by and large, similar to what I was accustomed to eating in my native land, there were many compromises made to Western taste. Sometimes, a dish was sweetened a little more than it would be if prepared for Chinese customers, or certain pungent ingredients were omitted or reduced, to better accommodate the Western diner’s palate.
Looking over a menu one day, I came across a dish I had never heard of before; even its name seemed foreign to me. Thinking that perhaps this was some rare regional delicacy, I ordered a plate, from curiosity if nothing else. What I got, served over white rice, consisted of small pieces of stir-fried meat and vegetables in a soy-based sauce. From the first bite, it was obvious to me that this was not Chinese at all: the choice of vegetables was odd, and the meat did not pair well with the sauce. In fact, it tasted distinctly American to me.
When I finished eating, I asked to speak to the manager, to see what I could learn about this strange dish. The manager, a Chinese man, was glad to explain it to me. There had been Chinese restaurants in America for a long time, he said, serving authentic Chinese food to an exclusively Chinese clientele. In the late 19th century, it seems there was a sudden interest in Chinese cuisine here in the States. Restaurant owners, good businessmen that they were, knew that they would have to adapt to their new customers’ tastes to take advantage of this trend.And so, their cooks, using Chinese ingredients and techniques, produced a dish that was “Chinese” enough for an American, but too American to be Chinese.
The result was “chop suey,” a purely American form of Chinese cuisine appearing on menus alongside more traditional dishes. It was not the real thing, but was close enough to satisfy the inexperienced.While this state of affairs continued for quite some time, with Western diners rarely venturing deeper into the menu, one would be hard pressed today to find any reputable Chinese restaurant attempting to present chop suey as authentic Chinese cuisine. Indeed, the dish is becoming a rarity. The reason is simple: with the passage of time, more and more Americans have come to be exposed to authentic Chinese cuisine, and, having once tasted the real thing, cannot be satisfied by any ersatz dishes.
This is, in many cases, what has happened to acupuncture and TCM studies in the West. In far too many cases, what is being taught bears only a tangential relationship to that upon which it claims to be based. With a sprinkling of Chinese terms and concepts, used, like the soy sauce in chop suey, to give the effect of authenticity without the substance, “Oriental medicine” is a wholly unsatisfactory substitute for TCM. We are confident that, with the passage of time, more and more Westerners will come to realize that “Oriental medicine,” like chop suey, is a wholly unsatisfactory accommodation to the limitations of many Westerners. With greater exposure to the authentic theories and practice of TCM, we can safely predict that Oriental medicine will go the way of chop suey, and will be remembered as a purely Western creation, an amusing footnote in the great history of the world’s most ancient form of medicine.
Paul C.K. Lin, M.A.; Lic.Ac. (TX)
Texas Health and Science University, formerly Texas College of Traditional Chinese Medicine