Materialist Thinking in Chinese Medicine

on 09/27/2012 by jonathanedwards in Foundational Science

Founders note: This post is from a new contributor, Jonathan Edwards, a student of Chinese medicine at NCNM and man of unbridled herbal enthusiasm. He runs a fantastic blog, particularly interesting to the herb nerds among us, over at Roots of Nourishment. Check him out – and make sure to leave him comments so he'll be so stimulated by the discussion, he can't help but contribute again!

Image by jayofboy (http://www.sxc.hu/profile/jayofboy)

Chinese medicine pop quiz: what do yin, yang, and qi have in common? I'll give you a couple minutes.

All right, I admit–it was a trick question. Because from my point of view, the only thing yin, yang, and qi share is that they don't exist. What?? Absurd! These are some of our most fundamental concepts, after all. But before you brand me as a heretic, allow me to make my case.

Does imagination exist? Does ephemerality? Of course they do–in a sense. In another sense, they don't. There's no "there" there. Nothing to point to, nothing to measure or to catch in the act. These are useful concepts, but let's not let the fact that they are nouns dupe us into thinking they have tangible referents. The philosopher Ludwig Wittgenstein pointed this out in the mid 20th Century: that even as it allows for communication and conceptual thinking, the structure of our language traps us in a web of our own devising.

We name abstract ideas so as to pin them down and be able to talk about them, then convince ourselves these concepts have an objective existence. It's a sort of circular reasoning.

I know only the smallest snippets of Chinese, but I would venture that the ancient Chinese, especially, had less of an issue here. The classical Chinese language's fluidity between nouns and verbs must have instilled a conceptual fluidity as well. The thinking in the Neijing, for instance, is more associative than both English and modern Mandarin, and less materialistic. The ancients have bequeathed to us the inestimable treasure of a time-based medicine that focuses on change and transformation instead of fixating, x-ray like, on one's physical state at a particular moment in time. We risk throwing it away if we see this emphasis on change as a liability and insist on pinning everything down to a material form.

So what about yin and yang and qi? I don't deny that these are essential concepts for us, and highly practical ones. That doesn't mean that there's such a thing as yin or yang, or indeed qi. They're not things; these terms are best understood as descriptions of processes.

They have as much to do with time as with space.

Maybe this seems like pedantic hair-splitting. But I've recently become aware of just how much our unconscious materialist conceptions influence our understanding and, ultimately, our practice of the medicine. TCM talks constantly of "yin deficiency," "yang deficiency," and "qi deficiency." I do not aim to ridicule these notions, as no doubt they can be useful clinically. But it's worth considering what we're really talking about. These terms can easily foster the image of the patient as a vehicle with separate tanks for yin, yang, and qi.

In this metaphor, the physician becomes little more than a technician, topping up whatever fluid is looking a little low. This picture is especially absurd when it comes to yang and qi, as these terms refer to specifically to immaterial processes. Yin can be understood as form, yang as function; in modern terms we might look to our metabolism and body temperature, what the Ayurvedic tradition calls our "digestive fire" (agni) as manifestations of yang. Seen this way, our yang–our level of vital warmth–can indeed by deficient.

But yang is not a fluid to be topped off, a tank that needs filling. Simply giving yang-tonifying herbs may not do the trick, since healthy yang relates to the functionality of the body as a whole. Perhaps we should hear the "yang" in "yang tonic" as an adjective: these are tonic herbs of a yang sort, as opposed herbs that tonify the yang.

Qi is in some ways a more difficult concept–and a topic for another article.

Suffice it to say that we might start paying more attention to the quality of the qi and less to its quantity. A diagnosis of "qi deficiency" should alert us to qualitative dysfunction at the level of the zang or the channels, not cause us to search for some way to "boost" the qi without taking care of the underlying disharmony. (The Nei Jing gets much mileage out of the word tiao, to tune or harmonize.) When obstructions are removed, the qi will flow. Each of us has the potential to serve as a conduit for as much qi as we could possibly need; my feeling is that the problem is never as simple as "there is not enough qi to go around."

Analogous points can be made for the five phases as well. Calling them "phases" rather than "elements" helps remind us that they are steps of a cyclical process. and as such cannot themselves be "excessive" or "deficient." I would go as far as to propose that we rename wood, fire, earth, metal and water "sprouting," "flourishing," "pivoting," "gathering" and "storing."

No one is likely to start talking about "sprouting deficiency!"

To close, most of the materialism so rampant in Chinese medicine is not the result of any deliberate ideological stand, just a by-product of our everyday, materialism-infused conceptions. This makes the situation more difficult to deal with, as it's bound up with the very structure of our language and thinking. But re-examining our Chinese medical terminology offers us a starting point for moving closer to the roots of the medicine.