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Ancient Chinese Medical Theory 101: Why Study Ancient Chinese Medical Literature?

My doctoral research focused on the Huáng Dì Nèi Jīng—the foundational text of East Asian medicine—so students and colleagues frequently ask me why the ancient medical literature is important. I have been thinking about this subject for some time now, and I am looking forward to sharing my own answers to this question over the coming weeks. Special thanks to the students, colleagues, and friends who have challenged me to think and rethink my position on what I believe to be a vital issue in our field.

 

Why Study Ancient Chinese Medical Literature?

The Yellow Emperor as depicted in a tomb from the mid second century AD.

This is a question I get asked frequently, but it is also one of the most difficult to answer. As a result, I have given much thought to an appropriate response, because I recognize that people want more than, “Ancient Chinese medical literature is the foundation of East Asian medicine.” These days, practitioners want to know precisely how the classics will make them more effective in the clinic, or how it will directly benefit their patients. I have never studied the ancient literature to achieve any practical clinical goal, so it is hard for me to answer from this perspective. My own journey into ancient Chinese medical theory was based purely out of curiosity and a desire to understand the roots of the medicine I was studying. As I mentioned above, I have given this question a lot of thought, and despite my own biases, the best answer I can presently give is, “Whatever you want to achieve in East Asian medicine, the ancient literature will take you there.”

On the surface, this new answer may appear just as vague as the original that I was trying to improve, but allow me to explain further; whether you practice TCM, Worsley-style Five Element Acupuncture, Japanese Meridian Therapy, Qigong, “integrative medicine,” or “functional medicine,” studying the ancient medical literature will benefit you. A few weeks ago, I published an article entitled, The Crisis of American TCM, in which I laid forth a number of my concerns about the overall state of academia in our field. One of my primary concerns is the lack of higher-order learning objectives being taught in many TCM and OM programs. Without going into too much detail, I feel that many of these programs are only giving students a surface understanding of foundational concepts like yīn-yáng theory and Five Phase theory. As a result, many students feel frustrated and/or confused by what seems to be an incomplete theoretical foundation on which to rely. The teachers in these programs do not bear sole responsibility, however, because the majority of them were trained within the TCM educational model—which only scratches the surface of what East Asian medicine truly has to offer. My concerns were validated by an outpouring of support and correspondence from former and current students of the medicine.

My Experience with Ancient Chinese Medical Literature

I was introduced to the Huáng Dì Nèi Jīng early in my Chinese medicine education, and for that, I am extremely grateful. Up until the point that I discovered the medical classics, TCM felt like a vapid shell comprised of disparate and often conflicting theories. Thanks to my teacher, Yanzhong Zhu, the classics became an adventure. He challenged my colleagues and me to cast aside the logical rationalism that has come to define our culture, and enter an ancient world of sages and immortals. In many ways, the divide between modern TCM and the ancient medical texts is as wide as the divide between modern biomedicine and the Hippocatic writings. Ironically, having read the Hippocratic writings, they seem to bear far more resemblance to ancient Chinese medicine then they do to modern biomedicine! But I digress…

The ancient Chinese medical texts helped to fill in the holes created by my education in modern TCM. Even more than that, they caused me to rethink my relationship to the world around me. Yīn-yáng theory is not as simple as we are taught in school. From the perspective of our universe, the interplay between yīn and yáng creates vortices, toroids, and wormholes. From the perspective of physics, yīn is potential energy and yáng is kinetic energy. In general, the nature of of yáng is to expand outwardly, and the nature of yīn is to contract inwardly.

Professor Yanzhong “Kevin” Zhu

I remember a specific time when Professor Zhu led me to a deeper understanding of yīn and yáng. I was traveling with a good friend of mine—who was also in the same TCM master’s program, and a scholar of the classics in her own right—to Hawaii for winter break. Before we left, Yanzhong, or Kevin as he is known to Five Branches University students, challenged us to: “Think about yīn and yáng in Hawaii. How are they different than here (Santa Cruz, CA)? How are they the same?” This challenge inspired a discussion on the beach several days later. My friend and I were contemplating the relative yīn-yáng dynamics of the landscape around us, which led to the question, “Which is more yáng, the beach, or the ocean?” The knee jerk TCM reaction would be: the ocean. After all, one of the primary manifestations of yīn—after Earth—is Water. On the other hand, while the beach may be warmer (yáng), the ocean is in constant motion (also yáng). Ultimately, we determined that the ocean, despite being Water (yīn), was more yáng than the beach, due to its unceasing motion. Whether this answer is definitive or not is of no concern. What matters is that we were challenged to think beyond the simple and basic associations that had been taught in our TCM Foundations class. I share this story with the hope that my experience may benefit others and inspire them to contemplate yīn and yáng.

As I continued through the master’s program, I became the teaching assistant for Professor Zhu’s Nèi Jīng class, and I did my best to share my passion for the classics with the students. I also realized that “the truth” about yīn and yáng or the Five Phases cannot be taught—it can only be understood through our interactions with the world around us. Yanzhong Zhu never told me what to think, he simply taught me how to think, using the mind of the ancients as a guide. For that, I will be forever grateful, since it lead me to where I am today. From the initial spark that was Professor Zhu’s class, I began reading not just the medical classics, but the philosophical classics of Chinese culture that were written at roughly the same time. I have now amassed a vast library of Chinese literature: with multiple translations of the Yì Jīng, Dào Dé Jīng, Zhuāng Zǐ, and Huáng Dì Nèi Jīng. My wife often jokes that the one thing we will always need more of is bookshelves!

I recognize that I have not yet given any specifics as to how the classics benefited my own practice of Chinese medicine, because the more I think about it, the more I realize that the value of the classics is beyond articulation. By reading the classics—even in the form of translations—we begin to see certain similarities with the descriptions of a particular concept across multiple texts. We begin to have an almost intangible understanding of this ancient wisdom, almost as though a portal has opened in the space-time continuum. There is something inherently mysterious or spiritual about this type of transmission that spans thousands of years. Having grown up on the East Coast, I recognize how un-academic and New Age-y that may sound, but it is my experience, nonetheless. Every time I read the Nèi Jīng, I find something new, or see something I hadn’t noticed before. Indeed, in my experience, the ancient texts seem to evolve as we do. This is my relationship with the classics, however: I don’t know what effect they will have on you. As I mentioned above, I never had any particular goal in mind when reading these ancient texts—I did it solely out of curiosity and a desire to better understand Chinese medicine. I cannot definitively tell you: “After reading the ancient literature, my practice volume increased by 10%, I used 27% fewer needles, and my patient retention rate improved by 7.3%.” For all I know, the ancient literature won’t have any effect on your practice—it may instead make you a better parent, or a better mountain biker, or a better person.

How Ancient Chinese Medical Literature Can Benefit You

800px-hua_t08

Image from Wikipedia

Despite my apparent inability to articulate the relevance of the classics outside of my own experience, I can say with some certainty that a familiarity with this ancient literature will deepen your understanding of the medicine. As both a student and a practitioner, I have observed the crucial role that intention plays in the clinic. In fact, scientists recognize the role of intention as well: it is the primary reason that the “gold standard” of scientific research is the double-blind placebo controlled study. Scientists recognize that if the researchers or the research subjects know who is in the control group or in the experimental group, the results of the study will be unreliable. What reason, other than intention, could account for this type of interference? A deeper understanding of yīn-yáng theory and Five Phase theory—or simply a better historical understanding of why we use certain points, herbs, or formulas in the clinic—will add more weight to our intention and, by extension, our clinical result. We will embody this knowledge during our verbal and non-verbal interactions with patients: effectively harnessing the same intention that scientists try to avoid in their research! Further, for those who practice “integrative medicine” or “functional medicine,” an understanding of the roots of Chinese medicine will enable you to more accurately integrate the theories of East Asian medicine and biomedicine. In order to create a functional model of integrative medicine, a knowledge of the ancient literature is essential; otherwise, the model will be built on the relatively weak theoretical foundations of “brand-name” TCM. According to the medical anthropologist Paul Unschuld:

The efforts…for a…legitimation of certain practices (i.e., acupuncture, application of drugs, and various other techniques)…may, in the long run, have provided more harm to the interests of traditional practitioners than benefit.  The elimination of the theoretical background of systematic correspondence threatened the existence of traditional Chinese medicine as a conceptually independent alternative, thereby contributing to a further, and potentially final, stagnation of this ancient knowledge (Unschuld, 1985, p. 261).

Supporting the New Generation of American Scholar-Practitioners

Unschuld wrote those words almost 30 years ago about the TCM model that America inherited from China. Traditional Chinese Medicine is the primary source of information for the boards and thus, American master’s programs. I still have hope that the stagnation brought about by the TCM model is not, as Unschuld posits, final. My hope lies in the students, who I believe are ready and eager to assimilate this ancient literature into a more complete system of East Asian medicine. This generation of students is currently being underserved, and while I am not advocating for a drastic overall of the entire American TCM juggernaut, I do hope that our schools can nurture this eagerness and enthusiasm before it is lost. Previous generations of practitioners have made significant progress toward greater pubic awareness of acupuncture and East Asian medicine as legitimate healthcare modalities; I believe that today’s students and practitioners must work to gain the same level of acceptance in both the biomedical and greater academic communities. This goal can be achieved through the creation of a new generation of scholar-practitioners, who deeply understand the theoretical underpinnings of the medicine. Only then can a high level of integrative medicine come about, in which East Asian medicine practitioners do not have to sacrifice the theoretical foundations on which our medicine rests. Further, by fostering a higher standard of academia within our own community, we will be better equipped to interface with other scholars—Anthropologists, Sinologists, Historians, and Linguists—who have been studying East Asian medical literature for decades and who may provide new insights into the history and practice of this great healing art. Ancient Chinese medical literature can play an important role in this process by inspiring future generations of students to gain a more in-depth understanding of Chinese medical theory than most master’s programs currently provide: thereby facilitating a renaissance of East Asian medicine in America. To quote Zhongjia Deng, a highly esteemed modern Chinese practitioner and educator:

The true nature of Chinese medicine comes…from a time that is a time of synthesis…the only way to do this justice is to find a type of educational model where you read the classics of this medicine that were written at the time when this synthesis occurred (Deng, 2005).

As I mentioned at the outset, this article is just the beginning discussion of a much larger topic. In the coming weeks and months, I will be detailing the specific texts and chapters for a number of topics, including: yīn-yáng theory, Five Phase theory, and herbal medicine. I am also considering a monthly group forum—an ancient Chinese literature book club, if you will—for those who would like a more interactive discussion of these topics. If you are interested, please sign up for my email list, and I will provide you with additional details when they become available. For those of you who would like to see how the ancient literature can be useful in your practice, I invite you to explore the texts and chapters associated with the following topics:

  • Chinese medicine as preventative medicine: Huáng Dì Nèi Jīng Sù Wèn Chapter 1
  • Yīn-yáng theory: Huáng Dì Nèi Jīng Sù Wèn Chapters 2, 3, 4, 5, & 6
  • Five Phase theory: Huáng Dì Nèi Jīng Sù Wèn Chapters 2, 3, 4, & 5
  • Herbal theory: Huáng Dì Nèi Jīng Sù Wèn Chapters 3, 4, 5, 9, 10, 14, 22, 23, 67, 70, 71, & 74.
  • Worsley-style Five Element Acupuncture: Huáng Dì Nèi Jīng Sù Wèn Chapters 2, 3, 4, 5, & 8; Huáng Dì Nèi Jīng Líng Shū Chapters 1 & 64; Nán Jīng Chapters 64 & 69

 

References:
Zhongjia Deng, (2005). Chinese Medicine Past and Present: Problems and Solutions. [Video file]. Retrieved from classicalchinesemedicine.org

Paul Unschuld, (1985). Medicine in China: A History of Ideas


© Dr. Phil Garrison and Ancient Chinese Medical Theory, 2014. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Dr. Phil Garrison and Ancient Chinese Medical Theory with appropriate and specific direction to the original content.

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