|Year : 2019 | Volume
| Issue : 2 | Page : 62-65
The importance of the Classics in the Transmission of Chinese Medicine to the West
Editorial Department, Monkey Press Publishing, London, England
|Date of Web Publication||19-Jun-2019|
Prof. Sandra Hill
Editor in Chief, Monkey Press Publishing House, London
Source of Support: None, Conflict of Interest: None
This paper discusses the role of the classical texts (Neijing and Nanjing) in the transmission of Chinese medicine – in particular acupuncture – to the West. This is presented in the following sections: A short historical overview of acupuncture practice in the UK; Philosophy of health and nourishing life (Yang sheng养生); The body as a complex system; Mind-body connections and the future of medicine and the problem of qi (气).
Keywords: Chinese medicine, Classical texts, philosophy of medicine, UK
|How to cite this article:|
Hill S. The importance of the Classics in the Transmission of Chinese Medicine to the West. Chin Med Cult 2019;2:62-5
| Historical Background|| |
The study of Chinese medicine was first established in the UK in the early 1970s, when a group of UK medical practitioners attended a series of seminars in London with Jaques Lavier. Three attendees of those seminars went on to establish schools in the UK. The College of Traditional Acupuncture was established by J R Worsley, who created his own style of treatment based on five phase (wu xing五行) correspondence. Van Buren went on to study stems and branches (天干地支) in both Taiwan and Korea, and later established the International College of Oriental Medicine (ICOM). A third college was established for doctors and other health professionals.
My own training began while living in Japan, where, in the early 1970s, acupuncture and herbal medicine were seen as quite separate disciplines, and acupuncture was still strongly influenced by its long history as a profession for the blind. In Japan, palpation skills are therefore very highly developed and have remained the most important part of acupuncture diagnosis and treatment. On my return to the UK in 1978, I enrolled at the ICOM, where I studied for 3 years, and later taught.
As students at that time, we were very aware of the lack of core material in English. The situation was much worse in the UK than in France. Very few text books were available and those that were of dubious origin. At ICOM, there was some attempt to refer to the Neijing (《内经》) and an attempt to teach classical philosophy. The only text book available in English was a partial and limited translation of the text by Ilza Veith. In the late 1970s, two books appeared in the West, published by Chinese publishing houses: An Outline of Chinese Medicine, and a year or so later, The Essentials of Traditional Chinese Medicine (TCM) – both of which were used as acupuncture point location text books and the latter as a basis for the understanding of TCM principles.
In the late 1970s and early 1980s, several ex-students of van Buren went to China and began to bring back TCM teachings. The first connections were made between teaching institutions in the UK and China. It is important to note that no training in herbal medicine existed in the UK at the time. Many UK acupuncturists embraced this more structured, more easily transmitted version of Chinese medicine. But, both Worsley and van Buren felt that these teachings were somehow too simplified and lacked the depth of their own work. It was in the early 1980s that the first factionalism began to appear between the old (possibly more classically based) and new (TCM) styles of working.
It was into this milieu that the teachings of French sinologist Claude Larre arrived in the early 1980s. He spoke at an UK acupuncture conference and was in discussion with German scholar Manfred Porkert on the nature of qi (气). Porkert's scholarship was very welcome at that time, and his books were the first to present classical ideas of qi (气), yin yang (阴阳), and wu xing (五行) in a structured way. He famously translated many of the Chinese medical terms into Latin – further confusing most UK students – and gave qi (气) 38 different names and qualities. Claude Larre reminded us that as practitioners we are dealing with human beings, that qi (气) is the substance of life, and that although we can dissect it intellectually, in order to treat patients, it must be felt and touched and experienced.
A Jesuit priest, Claude Larre had spent several years in China, Vietnam, and Taiwan – he was a classical Chinese scholar, and his doctorate from the University of Paris was on chapter 7 of the Huainanzi (《淮南子》), Jing Shen (精神). He established the Ricci Institute in Paris and devoted some 20 years to the task of creating the Ricci dictionary – a seven volume Chinese/French dictionary, which was at that time the most comprehensive classical dictionary available in any Western language.
With Elisabeth Rochat de la Vallée (sinologist and Chinese medical practitioner) and Western medical doctor Jean Schatz, he began translation and teaching of the classical medical texts of the Neijing and later the Nanjing – always informed by his deep understanding of the philosophical texts on which they draw. He taught regularly in the UK until his death in 2001, when Elisabeth Rochat continued the work.
For many of us, confused or bemused by the factionalism that had developed within the UK schools, this introduction to the very practical philosophy of classical Chinese medicine provided a foundation for our practice, teaching, and further study. In 1987, three students of Claude and Elisabeth established Monkey Press publishing to make their teachings more available to an English-speaking audience. This is the work that I have continued.
Since that time, Chinese medicine in the UK has changed considerably – more Western practitioners have studied Chinese, and more translations are available. But, there is still very little scholarship devoted to the Neijing, and most academic work has tended toward the transmission of herbal medicine.
| Importance of the Classical Texts|| |
Although the classical medical texts contain much information on pathology and the treatment of illness, this has also been added to, refined, and maybe improved over the centuries. My interest in the texts is more in their ability to define health and to provide an understanding of the correct functioning of the body and its energetic systems. The texts do not simply provide a method to treat symptoms but a system of medicine which is able to promote and maintain health – a philosophy of health and well-being.
A philosophy of health
Medicine in the West has lacked a philosophy of health for many decades. Even common sense about health which would have been abundant in our grandparents' lifetimes, has been reduced by a medical system based on drug taking and dependence on machines to tell us whether we are well or sick.
One reason for the popularity of Chinese medicine (and possibly other forms of alternative medicine) in the UK is that it gives the patient a context for their illness. It explains how this condition may have arisen and is able to suggest ways in which the patient may be able to engage with their own healing process.
The early chapters of the Neijing Suwen explain the reasons for health and disease in terms of fluctuations of yin yang (阴阳) and the resonances of wu xing (五行) and suggest that human beings should model their behavior on the four seasons (si shi四时) to remain in balance with the qi (气) of the universe.
“The four seasons of yin yang (阴阳) are the end and the beginning of the 10,000 things, the root of death and life. Going against their succession destroys life, going with their succession prevents illness. This is to obtain the way.” (Suwen chapter 2)
It may seem that these ideas would be foreign and unacceptable to westerners, but they are usually accepted as simple “common sense.” Traditional systems of medicine are similar worldwide because they apply observation of nature and observation of the human condition. The system of Greek medicine is in fact very similar in its reference to the seasons, humors, body types, and internal organs – though Chinese medicine is essentially concerned with constant change and transformation (bian hua变化), whereas the Greek system is more interested in material constituents. The traditional Greek system remained central to medicine in Europe until the last century and is still used by some traditional naturopaths and herbalists. As human beings, living on the earth, we share the experience of living in a physical body. Chinese medicine has a special role to play in human health because its traditional medical systems have remained intact over the centuries.
The early chapters of the Neijing Suwen establish the basic principles of health and disease, the laws governing the zangfu (脏腑), which allow the practitioner to apply the tools of the medicine with skill and understanding – not simply to follow a prescription. They allow the practitioner to treat each patient in their individual life situation, rather than applying the same treatment to a western disease name, and to teach individual patients to maintain their health and nourish their life so that disease will not recur.
The understanding of the human condition expressed in the classical texts can be felt and understood by all human beings. We have become divorced from our natural “body knowing,” and the health crises of the modern western world come directly from this lack of understanding. We need a philosophy of health and well-being that will help to combat unhealthy lifestyles. The teachings of the medical classics can help us to regain that understanding.
The body as a complex system
Western scientific medicine has little understanding of mind/body relationship, or of the relationship between different parts of the body. The body has been dissected – but never quite reassembled and understood as a working whole. As biomedicine became more highly specialized, it also became more fragmented. This specialist approach has helped to create the many significant breakthroughs of modern medicine, but it has become increasingly difficult to understand the relationships between the different parts.
Some researchers in the UK are discussing what they call “network pathologies” – symptoms which affect the whole body, or the relationship between its parts. Michael Highland, Professor of Health Psychology at Plymouth University, has suggested:
“Complexity theory shows us that the properties of some complex systems – networks in particular – cannot be attributed to individual components but emerge from whole systems. So why shouldn't disease emerge from the body in a similar way? If so, conventional medicine (scientific biomedicine) will never be enough to cure all our ills. And the assumptions of complementary and alternative medicine may not be as unscientific as they seem.”
Many of the terms used in modern physics and systems theory reflect the terminology of classical Chinese medicine. The body can be seen as a complex system, which is inherently self-regulating. Classical Chinese medicine provides a way to see the body and mind as a dynamic self-regulating interconnected whole.
The modern life sciences have much in common with the language of Chinese medicine. Ideas of connection, networks, and information patterning are alien to western biomedicine, but fit quite comfortably with systems theory, chaos, and complexity. The new life sciences recognize what they call “web-like patterns of organization” within living systems, which “maintain the integrity of the whole while undergoing continual structural change.” Life processes are described as circular rather than linear, the regulation of body temperature, and blood chemistry as “emerging” through the cyclical interrelationships of body systems. They describe “matrixes of messaging material;” mind as immanent within all matter – life as immanently “self-healing.”
If we reduce Chinese medicine to a system of formula for disease patterns, we lose its most valuable asset – that of understanding the body – and the body/mind – as a whole.
Western scientific medicine has no language to describe the relationship between mind and body, although as human beings, we all experience their obvious interconnections. Today, western-trained doctors will discuss “stress” as a cause of disease and label certain conditions “psychosomatic” – often when they can find no other cause or cure. But, there is no concept of the way that different emotions may affect the body in different ways. Classical Chinese medicine describes emotion as having a very specific effect on the qi (气):
“Elation and anger (xi nu喜怒) injure the qi (气).
Cold and heat injure the bodily form.”
and also the relationship between the emotions and the five zang (五脏):
” Heaven has four seasons (四时) and five phases (五行) for giving life, growth, limit and storage, and to produce cold, heat, dryness, damp and wind.
Human beings have five zang (脏), and through transformation, five qi (气) which produce elation (喜), anger (怒), sadness (悲), oppression (忧) and fear (恐).”
By attributing to each emotion a specific effect on the qi (气), we begin to understand the ways in which our emotions affect the physical body. This is described in Suwen chapter 39:
“In anger the qi rises up
In elation the qi becomes loose
In sadness the qi disappears
In fear the qi descends…
In fright the qi is in disorder
In obsessive thought the qi is knotted”
怒 则 气 上
喜 则 气 缓
悲 则 气 消
恐 则 气 下
惊 则 气 乱
思 则 气 结
This passage provides an elegant example of the concept of mutual resonance (gan ying感应) – and the way in which the movement of qi follows the movement of the five phases and in turn has an effect on the five zang (wu zang五脏).
The future of Chinese medicine in the West and the problem of qi (气)
The Chinese medical community within the UK often struggles to define its place in the modern world and is sometimes tempted to discard the more “archaic” elements of its past in an attempt to become more modern and scientific. But perhaps, we should engage more fully with the “strange” and “unexplainable” aspects of Chinese medicine and examine those aspects in the light of the new disciplines in science.
During the time that I lived in Japan, I worked with physicists attempting to understand the nature of qi (气). Can it be defined? Can it be measured? What are the meridians (经络)? We imagined that in 20 years' time, we would have more of an understanding of these subtle mechanisms of life. But instead, we have tended to push those unexplainable aspects of the medicine into the background, while we concentrate on proving that acupuncture is useful in treating back pain.
But what if a scientific investigation into the nature of qi (气) could provide insight into the subtle interconnections of the immune system, the nervous system, and the endocrine system? Maybe the very precise descriptions of qi flow within the traditional texts could inform emerging disciplines such as psychoneuroimmunology? What if an investigation into the classical insistence on “spirit” (shen神) was able to throw new light on the role of consciousness in healing?
And maybe, new research in embryology will find that there is some residual cellular memory connecting tissues of similar origin as they migrate through the developing fetus that can explain some of the more obscure connections made within both meridian (jing luo经络) and zangfu (脏腑) theory. With increasingly subtle tools available for exploration, and the fields of biochemistry and biophysics moving toward more subtle levels of knowledge, maybe we will come closer to understanding the more obscure aspects of our medicine.
It is by looking into the very mechanisms of life that the new sciences of biophysics and biochemistry are returning to a holistic and self-organizing view of the world. And with this return to an understanding of patterns of relationship, and the emergence of self-organizing structures, there is a new reverence toward life.
The language of the Chinese medical classics fits very well with the language of this new science. It is important that we do not discard this information as archaic and out of date. We may find that it will be the source of the medicine of the future.
| Conclusion|| |
Chinese medicine is a wide and all inclusive discipline. My hope is that it flourishes in the West in all its possible diversities. But in the attempt to make this medicine acceptable to a modern scientific community, I hope that we do not lose sight of the deep wisdom and detailed observation contained within the classical texts. It is my belief that the study of these texts is necessary to understand the depths of the medicine and to create a more effective medicine for the future.
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Conflicts of interest
There are no conflicts of interest.