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Book Review: Mystic, Shaman, Oracle, Priest by Michael Saso

1a. MYSHOP coverThis post features Annie Pecheva, who writes a great blog on Daoism, Chinese cosmology, Chinese astrology, and Chinese medicine. In this joint book review, Annie and I discuss our thoughts on Mystic, Shaman, Oracle, Priest: Prayer Without Words by Michael Saso.


Pecheva:
 Based on many years of in-depth study and profound experience of several different spiritual traditions, the new book by Professor Michael Saso, Mystic, Shaman, Oracle, Priest (MYSHOP), provides many high-level insights and discloses some rare details about the spiritual practices described therein. It is written sincerely, in a unique multi-layered style, with many interesting personal anecdotes interspersed between the various spiritual teachings.

1d. Yamada Eitai Ozasu Goma

Yamada Eitai Sama offering the Goma (Agni-hotra) fire rite.

The author takes us on a sacred journey, where we encounter practicing Daoist masters from China and Taiwan, Buddhist monks in Tibet and Japan, and an assortment of other priests, mystics, mediums and spiritual healers from around the world. Readers will experience a Piegan-Blackfoot medicine dance in Montana and sacred Cham dances in Tibet, meet a charismatic mudang shaman in Korea and danggi trance mediums in Taiwan, perform the Agni-Hotra fire rite in Japan, and survey sacred heiau sites in Hawai’i with a Kahuna.

Garrison: Professor Saso’s engaging narrative style brings the reader on a cross-cultural pilgrimage. Beginning with the author’s own experiences as a Jesuit novice in California, we travel with him to different parts of the world to encounter masters from different faiths and traditions.

 

Daoist Master Zhuang

Daoist Master Zhuang

I was particularly captivated by the section on Daoism, since I visited Long Hu Shan several years ago while in China. Those who have read The Teachings of Daoist Master Zhuang will feel right at home, as we are once again transported to Zhuang’s residence in Taiwan. In addition to containing transcriptions of the author’s conversations with Zhuang, this section also chronicles Professor Saso’s quest to return a number of sacred texts to their rightful monasteries. These texts were smuggled out of China and brought to Taiwan by Lin Rumei in 1868-1869. The task was appointed to Lin by the 61st Celestial Master of Long Hu Shan monastery, who had a prophetic vision that the texts would be destroyed if they remained in China. The texts eventually made their way to Master Zhuang’s maternal grandfather, and they were passed down to Zhuang, whose dying request was that Professor Saso return them to their monastic homes in China. We travel with the author on his historic quest, visiting the monasteries and monks at Mao Shan, Long Hu Shan, and Wu Dang Shan.

Pecheva: To those who are interested in the Yijing (Book of Changes), MYSHOP discloses details that are seldom found elsewhere. Professor Saso provides a thorough explanation of how the principles of the Yijing are used in Daoist meditation and ritual—from the sacred Daoist dance of the eight trigrams (the “steps of Yu”), to the four coded mantic words in the Yijing (元亨利贞) and their relation to the four stages of Daoist meditation, to the eight trigrams as the eight steps of cyclical change in Nature.

Garrison: The four coded mantic words in the Yijing were fascinating to me. I was particularly intrigued by this section, because all four words occur in the first two hexagrams: Qian (pure yang) and Kun (pure yin). Moreover, the meanings of these four words closely correspond to the four seasons which, themselves, are a tangible expression of the ebb and flow of yin and yang. Although many scholars have written about the seasonal aspects of the Yijing, the explanation of the four coded mantic words is unique to MYSHOP. The fact that the first two hexagrams contain all four mantic code words is particularly significant…almost as though the hexagrams themselves are speaking to us and revealing their secrets! In Professor Saso’s words: “The Yijing uses the 64 simple statements, written at the beginning of each hexagram, as a coded way to respond to external change, and keep our hearts in harmony with nature (p. 59).”

 

Ikkyu, the great 15th century koan master.

Pecheva: In addition to the Daoist tradition, Saso’s book explores the works of Teresa de Avila, Juan de la Cruz, Ignatius of Loyola, Lao Zi, Farid ud-Din Attar, Moses de Leon, and others. With deep respect to all sacred teachings, the author points out that apophatic (no-word, no-judgement) prayer and meditation is shared by many faiths and traditions, and represents the best path to inner—and world—peace. Professor Saso defines “the basic structure of a universally valid apophatic path (p. 35),” as:

1. Cleansing all negative words and judgement

2. Filling the mind with sacred images

3. Emptying the mind of all images

4. Union with Transcendent, absolute presence

Garrison: It is also noteworthy that the author includes a few caveats for potential travelers of the apophatic path. He acknowledges the commercialization of certain spiritual practices in the West, and the rise of “meditation-for-profit” teachers. He dispels the myths surrounding popular Western ideas like “The Dao of Sex,” and reminds would-be “shamans” that shamanic initiation traditionally comes in the form of a near-death experience, or prolonged periods of intense suffering. In the world of MYSHOP, spirituality cannot be bought, or learned from a weekend course—perhaps the hardest lesson to accept in our modern society of instant gratification.

In the author’s own words:

Sometimes I think that China does much more to preserve its minority cultures and languages than does the United States. The various ethnic cultures of Yunnan, the Muosuo, Nakhi, Pumi, Aini, Miao-Hmong, Yao-Mien, and others, all maintain their own unique languages and cultures. Their languages are taught in the universities of China. In the Pacific Northwest of the United States, only the Crow and Kootenai languages seem to be intact. Medicine and so-called shaman practices have survived better in popular movies and fiction (p. 158).

The climax of the

The climax of the “deer dance,” celebrated at Ta-er-si monastery, Qinghai, north Tibet.

Let us hope that the experiences and wisdom of Professor Michael Saso will inspire future generations to keep these practices alive in their authentic, non-commodified, form.

Pecheva: On a deeper level, Mystic, Shaman, Oracle, Priest serves as a mantra that brings wisdom, light and blessings to its readers. The deep wisdom it contains encourages the reader to practice apophatic meditation and be at peace with oneself, humanity, and the world.

Special thanks to Professor Michael Saso for providing the photos that appear alongside this review. Mystic, Shaman, Oracle, Priest can be purchased here.



Anna Pecheva

About Guest Blogger Annie Pecheva
Annie Pecheva has studied at Peking University in China and Stanford University in California. The author of several books on Chinese medicine, Qigong and Chinese metaphysics, she currently works at Hanlin Academy (Bulgaria) giving lectures and seminars, and running a small publishing house. The main focus of her studies and research include Daoism, natural cycles, and health preservation. Check out her blog: http://anniepecheva.blogspot.com/


© Dr. Phil Garrison and Annie Pecheva, 2015. 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 Annie Pecheva with appropriate and specific direction to the original content.

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Ancient Chinese Medical Theory 101: Do I Need to Learn Chinese? (Part 2)

Roughly one year ago, I posted this blog in which I argued against the notion that the ability to read Chinese is a prerequisite to an understanding of the classics of Chinese medicine. The gist of my argument was that there are a number of great English translations of the medical classics currently available—in addition to some superb translations of other Chinese classics—and so English-speaking students should be encouraged to read them. I also suggested that those within the Chinese medicine community who can read classical Chinese should be cautious not to perpetuate the notion that the classics must be read in Chinese, or that any understanding of the classics gained from translations is superficial; statements like these only serve to discourage students. Further, I stressed the idea that a deeper study of the medical classics requires, at minimum, a basic familiarity with ancient Chinese history and philosophy (which can be gained through both English and Chinese sources). I still stand by these claims. What follows, then, is my experience of stepping into the world of Chinese language…

Nei-Jing-300x249Background
My interest in the Chinese language began midway through the master’s program at Five Branches University. I loved the medical classics of the Han dynasty, and I knew that one day, I wanted to read them in the original Chinese. After graduation, one of the reasons I chose to pursue a doctorate at the Pacific College of Oriental Medicine (PCOM) was because the program included Chinese medical language. I was exceptionally fortunate to have a brilliant teacher for the first two semesters of study. She could tell I was seriously interested in the language and was very helpful and encouraging—in fact, she later served as the chairperson of my DAOM committee! Over the course of those two semesters, she taught us the basics of Chinese language and grammar. She did more than that, though, because she also taught us how to use Wenlin for the purposes of translation. Knowing how to use Wenlin has saved me countless hours of looking up unfamiliar characters in a dictionary (though decent translation still requires the use of multiple dictionaries).  We worked with Paul Unschuld’s book, Learn to Read Chinese (Vol. 1), and we also discussed the often heated debates between notable translators in the field of East Asian medicine. With her as my guide, in two semesters, I had reached the outer gate of Chinese medical language. After that, she resigned from her post to focus on her PhD, and the remainder of my language training at PCOM consisted of learning characters that were especially relevant to Chinese medicine.

To be completely honest, other than my training at PCOM, I didn’t really spend much time with the Chinese language until last year. As a teacher, I still used Wenlin to add the Chinese characters (and Pinyin) of herb names—and the characters for key concepts like , yīnyáng, and xíng—to my class notes, but I never really went beyond that.

And then there were the scholars

ChineseScholarEnter the Scholars
Less than a year ago, I started a Facebook group, called Scholars of Chinese Medicine, to provide a place for practitioners, teachers, and students to discuss Chinese medicine on its own terms. A place where disputes were settled by citing sources, and where the classics were quoted frequently. To my great joy, there were others who shared this vision, and we have worked collectively to create a vibrant online community that currently has over 2,100 members. Whether due to divine providence, sheer dumb luck, or a fortuitous combination of both, some major scholars began participating in the group.

And with them came the Chinese characters.

On occasion, when some member of the community would ask a question, the response would come as a stream of Chinese characters. Thanks to my previous training, I began copying and pasting these characters into Wenlin in an attempt to decipher the different responses. After a while, I got better at it. I also noticed that many of the citations were coming from sites like The Chinese Text Project or The Qi, so I began familiarizing myself with the different texts available online. I recognized the names of the Huáng Dì Nèi Jīng (黃帝內經), Shāng Hán Lùn (傷寒論), and other classics, and I noticed that there were commentaries to these books available as well.

So I got curious, and I started looking at the Shāng Hán Lùn and Nèi Jīng, along with their different commentaries—nothing monumental, just a few key lines at a time. Depending on the author, time-period, and writing style, I was occasionally successful…and occasionally frustrated. With practice, my skills improved. To give a frame of reference: when I began, 1-2 lines of text would take about 15 minutes, and a larger paragraph could take up to 2 hours. Now it takes roughly 1/3 that time.

DAOM defenseTranslations in the Classroom
My newfound comfort with these resources was a big help in the classroom, and it enabled me to give the students something more than they would have gotten otherwise. Being an English-speaking teacher of the classics, who is teaching English-speaking students, there are limited resources available. These additional resources in Chinese were a great addition to the curriculum. Let me be clear: having one English translation of a medical classic is reasonable for a curious student or practitioner, but to teach the classics at the doctoral level, one needs to look at multiple source texts (even if they are all in English).

More to the point, sometimes the answers to ambiguities in the classics can only be elucidated by looking at commentaries—and not just one commentary, but multiple commentaries on the same line! These commentaries are in Chinese, and would otherwise be inaccessible, if not for my limited language skills. Thus, in addition to having multiple English translations and numerous articles on the classics, the ability to access over 1,000 years of commentary from Chinese authors was an invaluable resource. For a scholar of the medicine (or, in modern parlance: a total Chinese medicine nerd), I’ll admit there was a certain glee that came with knowing I was reading commentaries that few of my English-speaking colleagues had even seen! And, from a teacher’s perspective, it was incredibly rewarding to give students access to this material.

Conclusion
I still stand by the claims that I made in my original post on this topic: that post was directed at students and practitioners who were interested in, but intimidated by, the classics. As a matter of practicality, English-speaking students should first study the classics in English, but those who are interested should be encouraged to go further. Whenever possible, teachers should seek to incorporate Chinese characters into their lessons, so that the students will feel more comfortable with them in both their present and future endeavors. Those English-speaking teachers who have some familiarity with the Chinese language should do their best to incorporate bits and pieces from different commentators into their lessons, as a reminder to students—and, hopefully, as an inspiration to a few—that Chinese medicine is a world of diverse opinions.

In my next post, I will share some of the resources that have been helpful to me in my own journey, and show you how to utilize them.


© Dr. Phil Garrison and Ancient Chinese Medical Theory, 2015. 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.

Discussing the Shang Han Lun: An Interview with Stephen Boyanton

Time to share this interview I did with Stephen Boyanton, who recently completed his PhD in the department of East Asian Languages and Cultures at Columbia University. Dr. Boyanton’s research focused on the Shāng Hán Lùn (傷寒論), one of the “classics” of Chinese medicine, which was written by Zhang Zhong-jing during the later part of the Han dynasty. You will find each part of the video below, along with descriptions of their content.


In this first segment of the interview, Dr. Boyanton details the sociopolitical factors that led to the rise of a new class of scholar-physicians in the Song dynasty. Proponents of this new literati medicine were especially fond of the Shang Han Lun, a collection of formulas from the later Han dynasty that developed a model of pattern differentiation based on the six channels.




In this part of the interview, Dr. Boyanton discusses the six stages, the influence of the Tang Ye Jing Fa on the Shang Han Lun, and general ideas about cold damage.




In this part of the interview, Dr. Boyanton discusses the variant editions of the text, issues of authenticity and authorship, and whether the text was part of a separate jing fang (“canonical formula”) tradition.




In this final segment of the interview, Dr. Boyanton discusses the distinction between the Shang Han Lun and other herbal formula texts that were popular prior to the Song dynasty (e.g. Sun Si-miao’s Prescriptions Worth a Thousand Gold Pieces and Ge Hong’s Prescriptions to Keep at Arm’s Length). In addition, he compares the Tang dynasty edition of the Shang Han Lun to the received version.



(c) 2015 Phil Garrison & Stephen Boyanton — All Rights Reserved*

*Please contact us if you would like to use these videos for educational purposes.

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Autism as Bai He Bing (百合病): A Chinese Medicine Perspective

Several months ago, I posted an article entitled, Autism as Shao Yang Disorder: A Chinese Medicine Perspectivein which I laid out a novel clinical approach to treating autism spectrum disorder (ASD) as a Shào Yáng (少阳) patternThat post inspired a fair bit of correspondence from other practitioners, so I thought it would be appropriate to follow-up with another classical disease (病) that might also be relevant to the treatment of ASD.

Autism Awareness ribbon

Before I begin, I’d like to clarify—as I always do with potentially “triggering” subjects—that I am NOT suggesting that Chinese medicine cures autism. I have witnessed both the lure of the “autism cure” that leads parents of autistic children/adults into a false sense of hope, and the subsequent disappointment when these therapies fail to meet expectations. In this article, I am offering a clinical theory rooted in the classics, and one that I hope will benefit your treatment of ASD. When treating autism with Chinese medicine, the goal should be the reduction of detrimental behaviors, the management of anxiety, and an increase in the quality of life for both the patients and their families. Ideally, Chinese medicine practitioners should try to work in tandem with the MD or specialist who handles the patient’s care from a biomedical perspective.


In early winter, I accepted a position teaching the Jīn Guì Yào Lüè (金匮要略)—a classic work on medical formulas from the second century CE—in the doctoral program at the Pacific College of Oriental Medicine. As I was preparing for a recent class, I was reminded of an obscure illness from that text called bǎihé bìng (百合病). Scholars have argued about the translation of bǎihé bìng, which either relates to Lilii Bulbus (the primary herb used to treat the disease), or a description of the syndrome (“Hundred Union Disease”). For the sake of brevity, I will avoid these semantic issues and leave the term untranslated.

Zhang Zhong-jing (Author of the Shang Han Lun and Jin Gui Yao Lue)

Here is the description of bǎihé bìng from the Jīn Guì Yào Lüè:

The classic says: bǎihé bìng, [the] hundred vessels [share] one ancestor, [so] all of them can cause disease. [The patient] desires food, but cannot eat; they are often quiet, and they desire to lie down, but cannot; they desire to walk, but are incapable of doing so; perhaps they desire food and drink at one time, but then the smell of food is offensive; they look like that are cold but without being cold, they look like they are hot without being hot; they have a bitter taste in the mouth; they have red urination; and no medicine can cure them. Even if the medicine causes intense vomiting, there is no benefit. They look like they are possessed by spirits or mischievous sprites, but the physical form seems harmonious; the pulse is faint and rapid. (Chapter 3, line 1)

As I began to contemplate this passage, my mind couldn’t help but zone in on the phrase, “they are often quiet.” Other (more experienced) translators have rendered this symptom as “frequent taciturnity” (Wiseman and Wilms, p. 69). The other statement that struck me was: “They look like they are possessed by spirits or mischievous sprites, but the physical form seems harmonious.” Having worked with individuals on both ends of the autism spectrum, I began to wonder if some forms of autism might be a type of bǎihé bìng. Interestingly, “bitter taste in the mouth” is a hallmark symptom of the Shào Yáng (少阳) stage disorders I described in the previous article on ASD, and “taciturnity” may manifest in certain Shào Yáng (少阳) stage disorders as well (Mitchell, Ye, & Wiseman, p. 410).

The treatment for bǎihé bìng is quite simple, and involves a decoction of only two herbs: the aforementioned bǎihé (Lilii Bulbus) and shēng dìhuáng (Rehmanniae Radix). Unfortunately, the original formula calls for the juice of shēng dìhuáng to be used, which is all but impossible to obtain. As such, my advice on dosages would be to follow the dosage ratio used in the research study below, or begin with the 2:1 ratio of shēng dìhuáng (生地黄) and bǎihé (百合) used in Bai He Gu Jin Tang and modify the dosages accordingly—up to 24g of bǎihé may be used (Bensky & Barolett, p. 161). Since the formula only involves two herbs, finding the proper dosage is crucial and may take several attempts, so it would be wise to inform the patient (or their family) ahead of time.

As I was preparing my lecture on bǎihé bìng for the students, I came across two additional pieces of information that support my theory. The first is from a book entitled, Understanding the Jin Gui Yao Lue, which states that: “this formula can be used in the treatment of a variety of neurological and mental disorders” (Sung, p. 74). The second was a recent study entitled, “Involvement of the Cerebral Monoamine Neurotransmitters System in Antidepressant-Like Effects of a Chinese Herbal Decoction, Baihe Dihuang Tang, in Mice Model” that was published in the journal Evidence-based Complementary and Alternative Medicine (Chen, et. al., 2012). This study concluded that “[Bai He Di Huang Tang] possess antidepressant-like effects…mediated, at least partially, via the central monoaminergic neurotransmitter system” (Chen, et. al., 2012). Since anti-depressant medications are often used in the treatment of ASD, this finding is significant. In fact, Temple Grandin, a professor at Colorado State University on the high functioning end of the autism spectrum, notes that: “My anxiety and panic attacks were 90% eliminated with a low dose of antidepressants” (TempleGrandin.com).

Taken as a whole, this modern research, and the description of bǎihé bìng from the Jīn Guì Yào Lüè, suggest that some forms of ASD may respond to treatment with Bai He Di Huang Tang—particularly in those patients who present with a faint and rapid pulse.


References

Chen, et. al. (2012) “Involvement of the Cerebral Monoamine Neurotransmitters System in Antidepressant-Like Effects of a Chinese Herbal Decoction, Baihe Dihuang Tang, in Mice ModelEvidence-based Complementary and Alternative Medicine.

“Frequently Asked Questions” (TempleGrandin.com)

Craig Mitchell, Feng Ye, and Nigel Wiseman, (1999). Shang Han Lun.

Sung Yuk-ming, (2010). Understanding the Jin Gui Yao Lue.

Nigel Wiseman and Sabine Wilms, (2000).  Jin Gui Yao Lue.




© Dr. Phil Garrison and Ancient Chinese Medical Theory, 2015. 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.

Early Chinese Medicine: An Interview with Donald Harper

 

Here is a recent video interview I did with Professor Donald Harper, centennial professor of Chinese studies at the University of Chicago. Dr. Harper is a specialist in early Chinese medical manuscripts and the period of Chinese history from the Warring States to the Han dynasty.

Wu Shi'er Bing Fang

Photo of the Wu Shi’er Bing Fang (Prescriptions for 52 Ailments), found at Mawangdui (1973 CE).

The interview begins with a brief description of the history and context of the Mawangdui medical manuscripts that were unearthed in Hunan province in 1973. Dated to 168BCE, these manuscripts include some of the earliest extant material on 脉 mài (vessel) theory, 导引 dǎoyǐn (guiding and pulling) exercises, sexual cultivation techniques, herbal medicine, and longevity practices.

Using Mawangdui as a starting point, Dr. Harper shares his insights on early Chinese medicine and discusses some of the recent archaeological discoveries, including the tombs at Laoguanshan, which contain a number of texts believed to be the work of the legendary 扁鹊 Biǎn Què or his disciples.

Along the way, Harper describes the “open fluidity” of medical ideas found in these ancient texts, which predate the more ideological 黄帝 Huángdì literature, and defines several terms that appear in the early literature, including 神明 shénmíng (spirit illumination).

f04da2db112214b9641b36The interview concludes with Dr. Harper’s description of a small lacquer figure that was found at the Laoguanshan site. For the first time in English, Harper details how markings on the figure itself provide new clues into 五行 wǔ-xíng (five agent) theory and 脏腑 zàngfǔ (organ) theory!

© Dr. Phil Garrison and Ancient Chinese Medical Theory, 2015. 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.

Categories: Uncategorized

Autism as a Shao Yang Disorder: A Chinese Medicine Perspective

Before, during, and after receiving my master’s degree in Chinese medicine, I worked with the special needs community. For a good portion of that 10 year period, I was an aide for young adults with Autism Spectrum Disorder (ASD). The experiences I had during that time were profound and life-changing. It is with great humility, and with the deepest respect for the autistic individuals with whom I came into contact, that I offer this post.

Before I begin, I’d like to clarify—as I always do with potentially “triggering” subjects—that I am NOT suggesting that Chinese medicine cures autism. I have witnessed both the lure of the “autism cure” that leads parents of autistic children/adults into a false sense of hope, and the subsequent disappointment when these therapies fail to meet expectations. In this article, I am offering a clinical theory rooted in the classics, and one that I hope will benefit your treatment of ASD. When treating autism with Chinese medicine, the goal should be the reduction of detrimental behaviors, the management of anxiety, and an increase in the quality of life for both the patients and their families. Ideally, Chinese medicine practitioners should try to work in tandem with the MD or specialist who handles the patient’s care from a biomedical perspective.

 

Autism: A Brief Synopsis
Information about autism can be gleaned from a variety of internet sources, so I’m only going to give a very brief synopsis here. Autism Spectrum Disorder (ASD) is: “a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior” (NINDS). As suggested by the moniker, autism exists on a spectrum, with a wide range of presentations. The majority of individuals I worked with were non-verbal, but on the other end of the spectrum, you have someone like Temple Grandin, who teaches at Colorado State University and writes best-selling books. Grandin describes autism as “a behavioral profile,” as opposed to a precise diagnosis (TempleGrandin.com).

Current Chinese Medicine Thinking
The perspective I will put forth in this article is novel—novel in the sense that I have yet to see a similar theory presented in an English-language Chinese medicine journal, lecture, or blog. As I mentioned before, autistic individuals occupy a wide spectrum, and each person is unique. As such, the range of symptoms and diagnoses (from a Chinese medicine point of view), varies from person to person. I am not offering a definitive Chinese medicine diagnosis for ASD, I am merely offering a diagnostic alternative to the standard TCM thinking, for practitioners who may not be satisfied with the typical ways of approaching autism in the clinic.

From a TCM perspective, there are many potential etiologies for Autism Spectrum Disorder. When I did a basic Google search for “Autism and Chinese Medicine, ” or “Autism and Acupuncture,” many of the same diagnoses popped up. The most popular etiology seems to be “Phlegm Misting the Mind.” That diagnosis may sound unusual—I’m sure the Quackwatch guy would have a field-day with it—but it basically means “clouded thinking” or “blunted affect.” There are two types of “phlegm” in Chinese medicine, “substantial” and “non-substantial” phlegm. A diagnosis of Phlegm Misting the Mind refers to the latter type. In other words, we don’t think there is literally phlegm in the brain! Treatment for this diagnosis primarily focuses on clearing phlegm and supplementing the Spleen, a TCM “organ” that creates phlegm when imbalanced. Again, for those who don’t know Chinese medicine theory, the “Spleen” referred to here is a holographic metaphor for a specific series of structures and processes in the body. [Note: I am using “holographic” in the same way that Michael Talbot uses the term in The Holographic Universe.]

Treatments for autism that I found on PubMed included: scalp acupuncture, tongue acupuncture, and electro-acupuncture. Some practitioners like to treat the Heart, others like to treat the Kidney. A more research-based “integrative medicine” approach suggests treating autism as an inflammatory process using a specific Chinese herbal formula (Lee & Kong, 2012). As you can see, there are a lot of treatment options!

The one option that is curiously absent, however, is the possibility of treating ASD from a six-stage perspective (popularized by Zhang Zhong-jing in the Shang Han Za Bing Lun). It is my belief that many manifestations of ASD are disorders of the Shào Yáng (少阳).

The Shào Yáng and Autism
According to the Huang Di Nei Jing (Su Wen Chapter 6), the foundational classic of Chinese medicine:

“In the division and unity of the three yang [vessels], the major yang (Tai Yang) is the opening; the yang brilliance (Yang Ming) is the door leaf; the minor yang (Shào Yáng) is the pivot” (Unschuld, p. 131).

Thus, the Shào Yáng regulates opening and closing, and disorders of the Shào Yáng are often described as “half exterior half interior” (Mitchell, Ye, & Wiseman, p. 407). What is important about this idea? The modern classical scholar, Li-hong Liu, has this to say about the Shào Yáng:

“There are three organs which are most prone to opening and closing. The mouth opens and closes for Yang (talking) and for Yin (receiving and chewing food). The throat opens and closes for Yang (breathing) and for Yin (swallowing food, drinks and saliva). The eyes open and close for Yang (to catch daylight and vision) and for Yin (to allow Yin storage and tears). If the pivot or the hinge is obstructed, the opening and closing will suffer…The action needed is to harmonize” (Seidman, p. 8-9).

Zhang Zhong-jing (aka Zhang Ji) 150-219 CE

Liu based this statement on his understanding of the Shang Han Lun, an important medical text written several centuries after the Huang Di Nei Jing. According to the Shang Han Lun, bitter taste in the mouth, dry throat, dizzy vision, and red eyes are general symptoms of Shào Yáng disorder (Mitchell, Ye, & Wiseman, 1999). Thus, Liu describes the mouth, the throat, and the eyes as “most prone to opening and closing” (Seidman, p. 8).

The concept of the eyes opening and closing is particularly relevant to ASD. According to the available information, as well as my own experience, one of the chief signs of autism is an inability to maintain eye contact (AutismSpeaks.org). Using Liu’s description as a starting point, failure to maintain eye contact could be considered a yin-yang imbalance of the eyes: when they open and close, there is either too much qi coming in (hypersensitive individuals) or too little qi coming in (hyposensitive individuals). If the term qi is too esoteric, consider replacing it with either “stimulus” or “information,” which are two types of qi.

The mouth, according to Liu, “opens and closes for Yang (talking).” As mentioned above, many of the individuals I worked with were almost completely non-verbal, and communication difficulties often plague higher functioning autistics as well (Stevenson, et. al., 2013). The Shang Han Lun lists “taciturnity” or reluctance to speak as another potential symptom of Shào Yáng disorders (Mitchell, Ye, & Wiseman, p. 410). This symptom is caused by “depressed Liver-Galbladder qi,” causing the “Heart qi to become constrained, which in turn affects the Heart’s function of governing the spirit” (Mitchell, Ye, & Wiseman, p. 413).

The ears may also be affected in cases of Shào Yáng disorders (Mitchell, Ye, & Wiseman, p. 408). Implementing the same logic that Liu uses in his discussion of the eyes, we can say that the ears have an opening and closing function as well (hearing/listening). In modern terms, the brain is constantly filtering—choosing which sounds to focus on or to ignore; in Chinese medicine terms, we could describe this process as the ears’ ability to open and close. Auditory processing is affected in ASD (Porges, et. al., 2014): when the ears are too open (incapable of filtering/isolating sound), this condition causes hypersensitivity to sound; when the ears are too closed (no sound getting through), this condition causes hyposensitivity to sound.

The Autism Awareness Ribbon

Conclusion
Based on my interactions with autistic adults and children, I feel that Shào Yáng disorder is an accurate representation of many presentations that I’ve seen. I’ve heard several high-functioning autistic adults describe the world as “overstimulating” from a visual and auditory point of view. Several of the individuals I worked with wore either sunglasses or sound-blocking headphones to compensate for the sensorial overload created by the world around them. According to the DSM-V, one of the diagnostic criteria for ASD is, “Hyper- or hypo- reactivity to sensory input or unusual interests in sensory aspects of the environment” (AutismSpeaks.org). In other words, the pivot isn’t working, so the sensorial “door” (to use the Nei Jing analogy) is constantly open (hypersensitivity) or closed (hyposensitivity). Based on the descriptions from autistic individuals, on Li-hong Liu’s analysis of the Shang Han Lun, on modern research, and on my own experience, I believe that ASD can be approached clinically as a Shào Yáng disorder.

In my own practice, I have used Xiao Chai Hu Tang for the withdrawn and non-aggressive manifestations of autism, and Chai Hu Long Gu Mu Li Wan for the hyperactive and aggressive manifestations of autism. Both of these formulas originate from the Shào Yáng section of the Shang Han Lun. Of course, no Chinese medicine theory would be complete without a pulse: the Shào Yáng pulse is either “stringlike and fine,” or simply “stringlike” (Mitchell, Ye, and Wiseman, p. 409).

Finally, the Shang Han Lun specifically states that in Shào Yáng disorder, “only one sign [means that] this is [the pattern], they do not all have to be present” (Mitchell, Ye, & Wiseman, p. 420). I mention this line for its clinical relevance: you may not be able to discern whether a non-verbal autistic patient has certain symptoms (bitter taste, fullness under the ribs, dry throat, dizzy vision). If there are sensory processing issues, taciturnity, and a stringlike pulse, you can be confident using the Shào Yáng formulas to treat—if you are so inclined!

References:
“Autism Fact Sheet” (NINDS.nih.gov)

“DSM-V Diagnostic Criteria” (AutismSpeaks.org)

“Frequently Asked Questions” (TempleGrandin.com)

David Lee & Xuejun Kong, (2012). “Potential Treatment of Autism with Traditional Chinese Medicine“. North American Journal of Medicine and Science, Vol. 5(3): 189-192.

Craig Mitchell, Feng Ye, and Nigel Wiseman, (1999). Shang Han Lun.

SW Porges, et. al. (2014). “Reducing Auditory Hypersensitivities in Autistic Spectrum Disorder“. Frontiers in Pediatrics.

Yaron Seidman. Three Yin and Three Yang: Clarifying Zhang Zhongjing’s Diagnostic Approach.

Ryan Stevenson, et. al. (2014). “Multisensory Temporal Integration in Autism Spectrum Disorders“. The Journal of Neuroscience, vol. 34(3): 691-697.

Paul Unschuld, (2011). Huang Di Nei Jing Su Wen.


© 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.

Ancient Chinese Medical Theory 101: Do I Need to Learn Chinese?

Several of my recent posts have focused on ancient Chinese medical literature, so I thought now would be an appropriate time to share my thoughts on the use of English translations in the classroom. There is a notion within the East Asian medicine community that in order to truly understand the ancient medical literature, it must be read in the original classical Chinese. This notion is perpetuated by some who feel that the literature is otherwise inaccessible to the English-speaking student. Unfortunately, it deters students from reading these ancient texts, and should therefore be abandoned. This article will focus on the specific ways that English-speaking students and teachers of East Asian medicine can utilize existing English translations of ancient Chinese medical literature (and other ancient Chinese literature) to gain a better understanding of the medicine. *Note: for the purposes of readability, I will simply refer to the Chinese language as a whole, instead of writing “modern Chinese and/or classical Chinese” each time. Astute scholars will recognize that the ancient medical texts were originally written in classical Chinese, but have since been transliterated into modern Chinese.*

DAOM defense

Doctoral Research Presentation and Defense

I do not read Chinese, yet I did my doctoral research on the Huáng Dì Nèi Jīng, the foundational text of Chinese medicine. More specifically, I created a consensus-based curriculum for this ancient medical text. To some in the field, it is inappropriate—even blasphemous—for an American who cannot recognize more than 100 Chinese characters to undertake research on the Chinese medical classics. In fact, I have heard tales of native Chinese teachers telling their American students that they will only be able to understand <50% of the Nèi Jīng without being able to read it in Chinese. Even American practitioners perpetuate this nonsense, and make statements suggesting that one can only get “the ‘impression’ of information, rather than the information itself,” when reading English translations of the ancient texts. Statements like these are disrespectful not only to students, but also to the translators of these great works.

Professor Yanzhong “Kevin” Zhu (Five Branches University)

Dr. Dong Ji, PhD (Pacific College of Oriental Medicine)

img_barry-xin

Barry Xin (Pacific College of Oriental Medicine)

Thankfully, my classics teachers, Yanzhong “Kevin” Zhu, Barry Xin, and Dong Ji, did not subscribe to this divisive viewpoint, and supported my enthusiasm for the classics, despite what others might have perceived as linguistic inadequacies. After graduation, I considered enrolling in a master’s program for classical Chinese, but I ultimately discarded the idea for practical reasons. It is unreasonable to think that every English-speaking student and practitioner of East Asian medicine needs to learn Chinese in order to gain an understanding of the classics. As a community, we must reject this idea that the ancient medical literature can only be accessed by those who read Chinese, because:

  1. It discourages English-speaking students from approaching the ancient medical texts.
  2. It leads to the implication that the classics are reserved only for those who can read Chinese.
  3. It is impractical and fundamentally flawed.

In many ways, classical Chinese is to modern Chinese as Middle English is to modern English. Take a look at this passage from Geoffrey Chaucer’s The Canterbury Tales:

Whilom, as olde stories tellen us,
Ther was a duc that highte theseus;
Of atthenes he was lord and governour,
And in his tyme swich a conquerour,
That gretter was ther noon under the sonne.

—The Canterbury Tales

Though it was originally written in Middle English, which ultimately developed into the form of English we speak today, it reads almost like a foreign language. Based on my limited understanding of the Chinese language, classical Chinese would likely appear as foreign to the modern Chinese reader as Middle English does to the modern English reader. So, the ability to read the ancient texts in the original classical Chinese is the privilege of a select few—even amongst native Chinese speakers! Luckily, there are Western scholars and academics who have already published stacks of research on the ancient medical literature. The ability to read Chinese is therefore just one potential way of approaching the classics; an understanding of ancient Chinese history, philosophy, and culture can be equally effective. The idea that simply reading the text in classical Chinese will give one a profound understanding of it is a fallacy!

Let me return to my example of The Canterbury Tales. Here is the modern English equivalent of the same passage quoted above:

Once on a time, as old tales tell to us,
There was a duke whose name was Theseus:
Of Athens he was lord and governor,
And in his time was such a conqueror
That greater was there not beneath the sun.

—The Canterbury Tales

Look back at the original. As a native English speaker, do you feel that something is lost in the translation to modern English? In my opinion, it would be far more beneficial to have some background on Theseus, or to have some understanding of the socio-political factors surrounding the time at which The Canterbury Tales was written.

Now let’s take a look at a passage from the Nèi Jīng Sù Wèn (Chapter 5):

Heaven is not sufficiently present in the North-West.
Hence the North-West is yin,
and the ears and the eyes of man on the right are not as clear as on the left.
The earth is incomplete in the South-East.
Hence the South-East is yang,
and the hands and feet of man on the left are not as strong as on the right.
—Unschuld, 2011, p. 116

Here’s the same passage translated by Elisabeth Rochat de la Vallee:

Heaven is deficient in the north-west, therefore the western and northern quarters are yin, and in man the ear and eye are not as clear on the right as on the left.

Earth is not full in the south-east, therefore the eastern and southern quarters are yang, and in man the hand and foot are not as strong on the left as on the right.

—Rochat de la Vallee, 2011, p. 122

…And the same passage translated by Ilza Veith:

Heaven is not complete with only the West and the North; the West and North are the regions of Yin.  Man’s hearing and eyesight are not so clear on his right side as they are on his left side.

The Earth is not complete with only the East and the South; the East and the South are the regions of Yang. Man’s left hand and foot are not so strong as are his right hand and foot.

—Veith, 1965, p. 122

We have now looked at three different translations of the same passage. Despite different word and grammatical choices, each of these passages conveys the same basic idea—with the exception of the specific directions. Is it North and West or Northwest? Is it South and East or Southeast? We could consult Maoshing Ni’s translation as well, where we would find “Northwest” and “Southeast,” but that still leaves the translators equally divided. Seemingly this is a question that could only be answered by an in-depth knowledge of Chinese language. But just as we could learn something about The Canterbury Tales through historical research, so too could we learn more about this passage through similar means. We could consult English translations of other ancient Chinese texts for the answer. I happened upon the answer in my readings of the Huái Nán Zǐ, a text that was written at roughly the same time as the Nèi Jīng:

Anciently Gong Gong and Zhuan Xu fought, each seeking to become the Thearch. Enraged they crashed against Mount Buzhou; Heaven’s pillars broke, the cords of the Earth snapped. Heaven tilted in the northwest, and thus the sun and moon, stars and planets shifted in that direction. Earth became unfull in the southeast, and thus watery floods and mounding soils subsided in that direction.

—Major, 1993, p. 62

This ancient legend, found in an English translation of the Huái Nán Zǐ, not only solves the directional ambiguity in the Nèi Jīng passage above, it gives us more to think about. The mythical conflict between Gong Gong and Zhuan Xu was probably so well known to the intended audience of the Nèi Jīng that the authors did not need to explain it further. Why did the ancient Chinese create this myth? Where is Mount Buzhou? I could answer those questions for you, but I’d rather inspire you to look them up yourself. I’ll even tell you where to look: John Major’s 2010 translation of the Huái Nán Zǐ (Chapter 3.1, p. 115; and the introduction to Chapter 4, p. 150). There you will find a description of Gong Gong, and the significance of Mount Buzhou: the mountain at the center of the Universe. You will learn that Mount Buzhou is the central peak on Mount Kunlun—a mountain that occupies the center of a 3×3 topographical grid in a cosmological theory that was popularized by Zou Yan, who is also famous for his role in the development of Five Phase theory. Mount Buzhou is the pivot around which the Universe turns. Why? Because, based the Earth’s orbit, the stars appear to move in a westerly direction around the celestial pole (Schafer, 2005). Mount Buzhou was the earthly counterpart to this celestial pole. In addition, due to the topography of China, the major rivers flow in an easterly direction toward the ocean. Simply put, this ancient myth was a way for the ancient Chinese to explain the celestial mechanics they observed from Earth, and to explain the directional flow of their rivers as well.

Did I lose you? Good. I want you to be lost. I want you to search for answers. I don’t want you to wait any longer to approach these ancient texts, and I certainly don’t want you to listen to the myopic views of those who would discourage you from doing so. Since I discovered the origin of this passage on my own, two additional Nèi Jīng books have been published that explain this particular chapter of the Sù Wèn (Kong, 2010; Rochat de la Vallee 2011). Every few months, more books and research papers are published in English that can help us to better understand East Asian medicine. The medical anthropologist, Paul Unschuld, has devoted his career to studying and translating the ancient Chinese medical texts—surely his translations of the Nèi Jīng and Nán Jīng should be suitable for all but the most erudite and discriminating scholar. Nigel Wiseman has produced outstanding translations of the Shāng Hán Lùn (with Craig Mitchell and Feng Ye) and Jīn Guì Yào Lüè (with Sabine Wilms) that contain excellent commentary. John Major has produced a detailed translation of the Huái Nán Zǐ. There are multiple English translations of the Yì Jīng, Dào Dé Jīng, and Zhuāng Zǐ—and the list goes on…

Long Hu Shan (Daoist Monastery)

Long Hu Shan
(Daoist Monastery)

Translation of the classics is just one piece of a much larger puzzle: one that also involves an understanding of the political and cultural factors that surrounded the creation of these texts. In fact, I chose the Nèi Jīng passage above precisely because it would still be ambiguous if you understood the Chinese language but lacked an understanding of Chinese mythology. You would still have to read the Huái Nán Zǐ, and though you could do so in the original Chinese, you would ultimately arrive at the same conclusion about this Nèi Jīng passage that could have been reached by utilizing existing English translations! By examining the work of Western scholars on topics like Chinese history and philosophy, we can gain a deeper understanding of the classics without ever learning Chinese. Let me be clear: I am not saying the work of translators is over—far from it—I am simply suggesting that students and practitioners not put limits on their ability to access the ancient medical texts. The field of East Asian medicine in America will always benefit from more English translations of the medical classics and their associated commentaries, but unless you are intent on pursuing a degree in classical Chinese, why not read the information available in English first? Then, if you are still driven to learn Chinese, I am sure you will be an amazing asset to our profession; for the rest of us, English translations can still be used to unlock the secrets of the classics.

As part of my doctoral research, I employed the method outlined here in the creation of a master’s level Nèi Jīng curriculum; I utilized multiple English translations of the Nèi Jīng for each passage, and then explained these passages with research from other disciplines. This method is, in my opinion, the best way to approach the ancient medical texts in the classroom—especially because the majority of American students are dependent upon English translations (Pritzker, 2014). Access to multiple English versions of each passage enables students to get a foundational understanding of the material, while research from scholars in complementary disciplines reinforces the concepts and theories described therein. I would like to see more teachers adopt this method in their classrooms. It undoubtedly takes more work, but the benefits to the students and to the profession are many.

Click to read part 2…

References:

Geoffrey Chaucer, (14th Century). The Canterbury Tales. Available online.

Y.C. Kong, (2010). Huangdi Neijing: A Synopsis with Commentaries

John Major, (1993). Heaven and Earth in Early Han Thought

John Major, (2010). The Huainanzi

Maoshing Ni, (1995). The Yellow Emperor’s Classic of Medicine

Pritzker, S., Hui, K.K., & Zhang, H, (2014). Considerations in the Translation of Chinese Medicine

Elisabeth Rochat de la Vallee, (2011). The Rhythm at the Heart of the World

Edward Schafer, (2005). Pacing the Void

Paul Unschuld, (2011). Huang Di Nei Jing Su Wen

Ilza Veith, (1965). The Yellow Emperor’s Classic of Internal Medicine


© 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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