Here is the second part of the article by my colleague Michael Givens. You can read the first part here. I hope we will see more of him here on Chinese Medicine Central. Please be sure to leave your thoughts in the comments, as he is a regular reader of the blog and will most certainly be interested in hearing what you have to say.
In the broad view it is simply the nature of Yin and Yang, yet it is also because Chinese medicine has had such a long fermentation process; the classical texts as we’ve understood them, present the view that I’ve described above, one of functional dynamics, but as Chinese society grew and changed, and as the West’s materialism influenced them, the lens of the Chinese doctors went through a few very important changes.
This is why it is so complicated. It is not “one medicine.” Like most things in China’s history, there has been a perpetual push to maintain an umbrella called “Chinese” for all things “Chinese” but this actually barely holds together. It is the same with the Chinese language: though there is a claim that the Chinese have had the same language for thousands of years, it is not completely true. What is true is that there is a continuous thread linking the oracle bones to modern Chinese, but that does not at all mean that it is the same language. The language meaning and usage within the context of culture and understanding could not possibly be the same.
With Chinese medicine, we could really isolate the different eras and dynasties and call these “Chinese medicine periods,” and there are some very real differences among them. Yet, the reason for our program is that there is a common root. There are the Shennong Ben Cao Jing, the Neijing, the Shang Han Lun, the Zang Zhong Jing, the Nan Jing, the Jia Yi Jing and the Maijing, for starters. Within these classical texts, while there are some significant differences and disagreements (even within the Neijing there are important discrepancies) it does seem that there is a common perception and worldview amongst them, a common understanding of the functional dynamism of human physiology and its correspondence to the movement of nature. However, after these texts and times, Chinese medicine becomes confusing and complicated.
This does not mean that anything written or practiced after Wangshu He in the second century CE is wrong by any means; it means that all of the formulas and treatments after this have to be carefully examined to gain any sort of understanding of the perceptions of those who created them. All Chinese scholars of all periods had a very deep and profound understanding of the classics, so in some ways we could say that what TCM (the Chinese medicine practiced and taught everywhere that has the approval of contemporary Chinese medical scholars of today) has to offer is the best of two thousand years of practice and scholarship.
But, I believe we are in a better position today than that. We are in the position to broadly see how human consciousness has traversed from immaterialism to materialism, from conceptualization of process and movement, to a conceptualization of matter and physical (Western) physiology, and today, we can see how we are now reaching about as far as a materialist view can go. This allows us to move forward to a new, yet much less material understanding. Western science is also running up to this point and it appears that a subtle, yet great paradigm shift is underway. I believe classical Chinese medicine can be at the forefront of this shift.
Thus, I am advocating for the importance of not acquiring too many useful tools of TCM, but rather to push Chinese medicine further by doing what the scholars of all times have had to do. It should be each one of our responsibilities to read, study, examine, practice and experiment with what the classical texts have to offer, before we try to see what others have done with them.
We should do this so that we can at the very least, understand why for instance, one scholar in Chinese history decided to modify Li Zhong Wan (a formula from the Shang Han Lun, Han Dynasty, 1st century, designed to “rectify” the spleen and “center” using the herbs: dried ginger, ginseng, atractylodes, and honey-fried licorice) and turn it into Bai Zhu Tang or the later more well known name, Si Jun Zi Tang (Four Gentlemen’s Decoction: Song Dynasty, 11th century, designed to strengthen the Spleen, using the herbs: ginseng, atractylodes, poria and honey-fried licorice), which is so widely used today.
Was it because he was more evolved in his understanding? Did he have a better grasp of the human body and human diseases, or did he simply have a different understanding of it; was he, perhaps more materialistic and narrow in his understanding? The only way for us to know, despite the fact that our teachers will advocate for one or the other, is to have a specific frame of reference. Otherwise, we just have to choose one or the other and see what happens. But, I believe that we will at some point, have to define for ourselves our own understanding of what medicine does and how the body works.
Of course, this is what we have been learning while at school, but it has not been consistent. The holistic view of classical Chinese medicine is not the holistic view of TCM, though TCM claims it is. The holistic view of one teacher, for that matter is not always the holistic view of another. Yet, based on what we have learned from the classical texts, classical holism is a dynamic interplay between function and matter, internal and external, time and space.
It is based on the concept that matter follows energy, and energy follows consciousness; this is what we have been taught, yet is easy to neglect. It is also essential to recall that, like (classical) Naturopathic medicine, classical Chinese medicine works primarily through helping the body (functionally, not materially) to regain balance rather than doing something to the body (supplementing materially) to re-establish balance.
The holistic view of TCM is simply that internal and external are mutually related, and that the laws of yin and yang and the five elements apply to both humans and to nature, that’s it. There certainly is the concept of functionality in TCM, but it is clear that material concepts are much more predominant, and this is seen in the way disease is treated.
For us to be able to effectively evaluate the various treatments and protocols from the thousand years of fermentation, we must be able to know when they are doing something to the body and when they are communicating a functional shift within the dynamic of the whole person. We can only know this by knowing the classical understanding of physiology. We really can only know classical physiology by understanding deeply the classical theoretical principles of nature and the cosmos.
I believe that we can only foster a growth and evolution of the future of Chinese medicine through deeply assimilating our perceptions and understandings to the perceptions and understandings of the ancient scholars. We must understand our medicine from a physiological, dynamic, functional perspective that takes in to consideration space (physical and relational), time (seasonal breath and astrological changes) and direction (momentum, flow, and interrelation) to begin to understand what was intended in the Chinese medical classics.
With this kind of an understanding, we can then easily evaluate classical and traditional Chinese formulas and treatments; more importantly, we will be able to develop new, yet classical methods of treating diseases, for we will be protecting the functions and warmth of life, flowing with the processes of nature, and never working against either.
Michael Givens – National College of Natural Medicine – 3rd year in Classical Chinese Medicine program